血清降钙素原鉴别诊断急性放射性肺炎与细菌性肺炎的临床价值

Differential diagnosis analysis of serum calcitonogen with acute radioactive pneumonia and bacterial pneumonia

目的探讨血清降钙素原鉴别诊断急性放射性肺炎(ARP)与细菌性肺炎(BP)的临床价值。方法选取2018年3月至2021年3月100例于本院接受放疗干预肺癌且合并急性肺炎患者作为研究对象,根据患者病情实际情况分为两组,ARP患者作为A组(n=64),BP患者作为B组(n=36)。比较两组临床资料及降钙素原、C反应蛋白和白细胞计数指标。结果A组放疗处方剂量≥62 Gy占比高于B组,平均肺受量<17.4 Gy占比低于B组,差异有统计学意义(P<0.05);两组年龄、性别、肿瘤组织学类型、肿瘤分期、受照射剂量≥20 Gy肺体积占全肺体积比例比较差异无统计学意义。A组降钙素原指标低于B组(P<0.05),两组C反应蛋白及白细胞计数比较差异无统计学意义。结论ARP患者相对于BP患者而言血清降钙素原指标浓度明显更低,如对患者检测后提示指标低于0.47μg/L时应考虑为ARP,进一步采取诊断措施以保障患者的身体健康。

Objective To investigate the clinical value of serum procalcitonin in differential diagnosis of acute radiation pneumonitis(ARP)and bacterial pneumonitis(BP).Methods A total of 100 patients with lung cancer complicated with acute pneumonia who received radiotherapy in our hospital from March 2018 to March 2021 were selected as the research objects.According to the actual condition of the patients,they were divided into ARP patients as group A(n=64)and BP patients as group B(n=36).The clinical data,procalcitonin,C-reactive protein and leukocyte count indexes of the two groups were compared.Results The proportion of radiotherapy prescription dose≥62 Gy in group A was higher than that in group B,and the proportion of average lung dose<17.4 Gy was lower than that in group B,the difference was statistically significant(P<0.05).There was no significant difference in age,sex,tumor histological type,tumor stage and the proportion of lung volume to total lung volume at irradiation dose≥20 Gy between the two groups.The procalcitonin index of group A was lower than that of group B(P<0.05),and there was no significant difference in C-reactive protein and white blood cell count between the two groups.Conclusion The serum procalcitonin concentration of ARP patients is significantly lower than that of BP patients.If the indicator is lower than 0.47μg/L,ARP should be considered.Further diagnostic measures should be taken to ensure physical health of patients.