外周白细胞VCS参数与血清降钙素原在老年细菌性肺炎诊断及严重程度评估中的应用

Application of VCS parameters of peripheral leukocytes and serum procalcitonin in the diagnosis and severity evaluation of bacterial pneumonia in the elderly

目的分析外周白细胞VCS参数与血清降钙素原(PCT)在老年细菌性肺炎诊断及严重程度评估中的应用。方法选取2018年1月至2020年1月于本院就诊的132例老年肺炎患者作为研究对象,根据痰培养结果分为细菌性肺炎组(n=59)和非细菌性肺炎组(n=73),细菌性肺炎组根据病情的严重程度分为轻度组(n=19)、中度组(n=23)及重度组(n=17)。选取同一时期于本院体检的45名健康老年人(无任何肺部感染及其他急慢性炎症)作为对照组。比较3组外周白细胞VCS参数及降钙素原(PCT);比较不同程度细菌性肺炎外周白细胞VCS参数及PCT;分析白细胞VCS参数及PCT诊断细菌性肺炎的ROC曲线。结果3组中性粒细胞平均体积(NV)、中性粒细胞平均传导率(NC)、淋巴细胞平均体积(LV)、淋巴细胞平均传导率(LC)及PCT比较差异有统计学意义(P<0.05);非细菌性肺炎组和细菌性肺炎组NV、NC、LV、LC及PCT均高于对照组,细菌性肺炎组NV、NC、LC及PCT均高于非细菌性肺炎组,差异有统计学意义(P<0.05)。不同程度细菌性肺炎患者NV、NC、LC及PCT比较差异有统计学意义(P<0.05);重度组、中度组NV、NC、LC及PCT均高于轻度组,重度组NV、NC、LC及PCT均高于中度组,差异有统计学意义(P<0.05)。ROC曲线结果显示,NV、NC、LC及PCT诊断细菌性肺炎曲线下面积(AUC)面积为0.751、0.688、0.690、0.791,诊断价值较好。结论VCS参数及PCT在不同程度细菌性肺炎诊断中具有重要意义,NV、NC、LC及PCT诊断细菌性肺炎具有较好的诊断效能。外周白细胞VCS参数及PCT水平在诊断老年细菌性肺炎与鉴别疾病程度中具有显著的辅助诊断价值。

Objective To analyze the application of peripheral leukocyte VCS parameters and serum procalcitonin(PCT)in the diagnosis and severity assessment of bacterial pneumonia in the elderly.Methods 132 elderly patients with pneumonia who were treated in our hospital from January 2018 to January 2020 were selected as the study subjects,they were divided into bacterial pneumonia group(n=59)and non-bacterial pneumonia group(n=73)according to the sputum culture results.The bacterial pneumonia group was divided into mild group(n=19),moderate group(n=23)and severe group(n=17)according to the severity of the disease.45 healthy elderly people(without any lung infection and other acute and chronic inflammation)who were examined in our hospital at the same time were selected as the control group.VCS parameters and procalcitonin(PCT)of peripheral white blood cells in the three groups were compared;VCS parameters and PCT of peripheral leukocytes in different degrees of bacterial pneumonia were compared;VCS parameters of white blood cells and ROC curve of PCT in diagnosis of bacterial pneumonia were analyzed.Results There were significant differences in neutrophils volume(NV),neutrophils conductivity(NC),lymphocyte volume(LV),lymphocyte conductivity(LC)and PCT among the three groups(P<0.05);NV,NC,LV,LC and PCT in abacterial pneumonia group and bacterial pneumonia group were higher than those in control group,while NV,NC,LC and PCT in bacterial pneumonia group were higher than those in abacterial pneumonia group,the difference was statistically significant(P<0.05).There were significant differences in NV,NC,LC and PCT among patients with different degrees of bacterial pneumonia(P<0.05);NV,NC,LC and PCT in severe group and moderate group were higher than those in mild group,while NV,NC,LC and PCT in severe group were higher than those in moderate group,and the difference was statistically significant(P<0.05).ROC curve showed that the area under the curve(AUC)of NV,NC,LC and PCT in the diagnosis of bacterial pneumonia were 0.751,0.688,0.690 and 0.791,which had good diagnostic value.Conclusion VCS parameters and PCT play an important role in the diagnosis of different degrees of bacterial pneumonia,NV,NC,LC and PCT have good diagnostic efficacy in the diagnosis of bacterial pneumonia.Peripheral white blood cell VCS parameters and PCT levels have significant auxiliary diagnostic value in the diagnosis of elderly bacterial pneumonia and the differentiation of disease severity.