C-反应蛋白、血清淀粉样蛋白A、血清降钙素原在社区获得性肺炎临床诊断中的应用价值

The value of C-reactive protein,serum amyloid A and serum procalcitonin in the clinical diagnosis of community acquired pneumonia

目的回顾性分析本院社区获得性肺炎(CAP)患者中C-反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、血清降钙素原(PCT)的检测结果。方法收集本院2017年8月-2019年2月呼吸科确诊的65例CAP住院患者和同时段本院健康体检的正常人群为对照组,CRP、SAA检测采用免疫比浊法,PCT检测采用电化学发光法,数据分析采用SPSS 20.0软件,比较不同组别间CRP、SAA、PCT水平是否存在差异,同时建立ROC曲线,计算最佳临界值。结果CAP组CRP、SAA、PCT水平均高于对照组(P<0.05)。CRP在检测CAP时的ROC曲线下面积为0.899,最佳临界值为4.01 mg/L,敏感度和特异度分别为72.3%、98.5%;SAA在检测CAP时的ROC曲线下面积为0.812,最佳临界值为7.0 mg/L,敏感度和特异度分别为79.7%、89.4%;PCT在检测CAP时的ROC曲线下面积为0.784,最佳临界值为0.05 ng/ml,敏感度和特异度分别为61.5%、89.2%。结论在社区获得性肺炎患者的诊断及感染状况评估中,CRP、SAA、PCT作为新的炎症标志物可以为临床的诊断及治疗提供有效的辅助。

Objective The purpose of this study is to retrospectively analyze the results of C-reactive protein(CRP),serum amyloid A(SAA)and serum procalcitonin(PCT)in patients with community acquired pneumonia(CAP)in our hospital.Methods A total of 65 CAP inpatients diagnosed by the Department of Respiratory Diseases from August 2017 to February2019 in our hospital were collected,and the healthy group after physical examinations in the same period were enrolled as the control group.CRP and SAA were tested by immunoturbidimetry method.PCT was performed by electrochemical luminescence method.The data analysis was performed by SPSS 20.0 software.The differences in the CRP,SAA and PCT levels between different groups were compared.The ROC curves were established and the optimal thresholds were calculated.Results CRP,SAA and PCT levels in CAP group were all higher than those in control group(P<0.05).When detecting CAP,the area under the ROC curve of CRP was 0.899,the optimal critical value was 4.01 mg/L,and the sensitivity and specificity were72.3%and 98.5%,respectively.The area under the ROC curve of SAA was 0.812 in the test of CAP,the optimal critical value was 7.0 mg/L,and the sensitivity and specificity were 79.7%and 89.4%,respectively.The area under the ROC curve of PCT was 0.784 in the test of CAP,the optimal threshold was 0.05 ng/ml,and the sensitivity and specificity were 61.5%and 89.2%,respectively.Conclusion In the diagnosis and infection status assessment of patients with community acquired pneumonia,CRP,SAA,PCT,as new inflammatory markers,can provide effective assistance for clinical diagnosis and treatment.