降钙素原在肺结核合并肺炎早期诊断中的价值

Early diagnostic value of procalcitonin in pulmonary tuberculosis complicated with pneumonia

目的探讨血清降钙素原(PCT)对肺结核合并肺炎的早期临床诊断价值。方法选取苏州市第五人民医院2020年7月至2021年6月收治的1 214例住院肺结核患者,根据患者是否合并肺炎分为合并肺炎组(587例)和未合并肺炎组(627例)。采用电化学发光免疫分析法检测血浆中PCT水平,应用Logistic回归分析和ROC曲线综合评价PCT早期诊断的价值。结果合并肺炎组和非合并肺炎组PCT水平分别为0.583(0.570,0.635) μg/L和0.379(0.370,0.402) μg/L,差异有统计学意义(Z=-3.017,P=0.003)。多因素非条件Logistic回归分析显示,PCT水平每升高1个单位,患者合并肺炎的危险度增加1.912倍(95%CI:1.217~3.003)。PCT早期判断肺结核合并肺炎的ROC曲线下面积为0.820,最佳临界值为0.561 μg/L,灵敏度为84.70%,特异性为89.51%。结论患者入院时PCT水平对肺结核合并肺炎的早期鉴别诊断具有临床应用价值。

Objective To investigate the value of serum procalcitonin(PCT)in the early diagnosis of pulmonary tuberculosis complicated with pneumonia.Methods A total of 1214 patients with pulmonary tuberculosis admitted to the Fifth People's Hospital of Suzhou from July 2020 to June 2021 were enrolled and divided into the pneumonia group(587 cases)and the non-pneumonia group(627 cases)according to whether they were complicated with pneumonia.Plasma PCT levels were determined by electro-chemiluminescence Immunoassay,and the diagnostic value of PCT was evaluated by Logistic regression analysis and ROC curve.Results The PCT levels in the pneumonia group and the non-pneumonia group were 0.583(0.570,0.635)μg/L and 0.379(0.370,0.402)μg/L,respectively,and the difference was statistically significant(Z=-3.017,P=0.003).Multivariate non-conditional Logistic regression analysis showed that patients were 1.912(95%CI:1.217-3.003)times more dangerous to complicate with pneumonia for every 1 unit increase in PCT level.The area under ROC curve was 0.820,and the optimal critical value for determining PCT diagnosis of pulmonary tuberculosis complicated with pneumonia was 0.561μg/L,with the sensitivity of 84.70%and the specificity of 89.51%.Conclusions PCT level on admission has clinical application value in early diagnosis of pulmonary tuberculosis complicated with pneumonia.