降钙素原和心肌酶谱水平与重度肺炎患者炎症反应的相关性和诊断价值分析

Analysis of Correlation of Procalcitonin and Myocardial Zymogram Levels with InflammatoryResponse in Patientswith Severe Pneumonia and theirDiagnosticValues

目的:分析降钙素原和心肌酶谱水平与重度肺炎患者炎症反应的相关性和诊断价值,为重度肺炎的判断和早期防治提供参考。方法:选取2020年1月—2021年10月柴桑区人民医院收治的187例重度肺炎患者作为观察组,另选取在医院体检的健康人员(n=60)和普通肺炎患者(n=60)作为健康组和普通组,分析肌酸激酶(creatine kinase,CK)、谷草转氨酶(glutamic-oxaloacetic transaminase,GOT)、乳酸脱氢酶(lactic dehydrogenase,LDH)等心肌酶谱指标和降钙素原(procalcitonin,PCT)与患者重度肺炎的相关性,并构建重症肺炎的预测模型。结果:健康组患者的CK、LDH、GOT水平均低于普通组和观察组患者(P<0.05),普通组患者的CK、LDH、GOT水平低于观察组(P<0.05);健康组患者的PCT、WBC、CRP水平均低于普通组和观察组(P<0.05),普通组患者的PCT、WBC、CRP水平均低于观察组患者(P<0.05);相关性分析结果显示,PCT、CK、LDH、GOT水平与WBC、CRP水平呈正相关(P<0.05);Logistic回归分析结果显示,PCT、CK、LDH、GOT是重度肺炎的独立危险因素(P<0.05);ROC分析显示,PCT、CK、LDH、GOT,以及PCT联合心肌酶谱指标对患者重症肺炎诊断预测的灵敏度分别为78.14%、48.52%、58.64%、54.37%、92.87%,而其特异度分别为86.92%、79.24%、84.73%、85.22%、91.45%。结论:PCT、LDH、GOT、CK与重度肺炎患者的炎症反应具有相关性,并且PCT联合心肌酶谱指标对患者重症肺炎诊断具有较好的预测价值。

Objective:To analyze the correlation of procalcitonin and myocardial zymogram levels with inflammatory response in patients with severe pneumonia and their diagnostic values,so as to provide reference for the judgment and early prevention and treatment of severe pneumonia.Methods:A total of 187 patients with severe pneumonia admitted to the People's Hospital of Chaisang District from January 2020 to October 2021 were selected as the observation group,and healthy individuals(n=60)who underwent physical examination in the hospital and patients with common pneumonia(n=60)were selected as the health group and the normal group,and the correlation of the myocardial zymogram indicators such as creatine kinase(CK),glutamic-oxaloacetic transaminase(GOT),lactic dehydrogenase(LDH),etc.and procalcitonin(PCT)with severe pneumonia was analyzed,and a predictive model for severe pneumonia was constructed.Results:The levels of CK,LDH and GOT of patients in the health group were lower than those in the normal group and the observation group(P<0.05),and the levels of CK,LDH and GOT of patients in the normal group were lower than those in the observation group(P<0.05);the levels of PCT,WBC,and CRP of patients in the health group were lower than those in the normal group and the observation group(P<0.05),and the levels of PCT,WBC,and CRP of patients in the normal group were lower than those in the observation group(P<0.05).The correlation analysis showed that the levels of PCT,CK,LDH and GOT were positively correlated with the levels of WBC and CRP(P<0.05);the Logistic regression analysis showed that the levels of PCT,CK,LDH and GOT were independent risk factors for severe pneumonia(P<0.05);the ROC analysis showed that the sensitivities of PCT,CK,LDH,GOT,and PCT combined with myocardial zymogram indicators in predicting and diagnosis of severe pneumonia were 78.14%,48.52%,58.64%,54.37%,and 92.87%,respectively,while their specificities were 86.92%,79.24%,84.73%,85.22%and 91.45%,respectively.Conclusion:PCT,LDH,GOT,and CK are correlated with the inflammatory response in patients with severe pneumonia,and PCT combined with myocardial zymogram indicators has a good predictive value for the diagnosis of severe pneumonia.