血清CRP、SAA、PCT水平检测在老年AECOPD患者下呼吸道细菌感染中的诊断价值

Diagnostic value of serum CRP,SAA and PCT levels detection in lower respiratory tract bacterial infection in elderly patients with AECOPD

目的:分析血清C反应蛋白(CRP)、淀粉样蛋白(SAA)、降钙素原(PCT)水平检测在老年慢性阻塞性肺疾病急性加重期(AECOPD)患者下呼吸道细菌感染中的诊断价值。方法:选取2019年2月至2021年5月该院收治的60例老年AECOPD患者进行前瞻性研究,统计其下呼吸道感染情况,并根据痰培养结果分为细菌组、真菌组和阴性对照组,比较三组血清CRP、SAA、PCT水平,并绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析血清CRP、SAA、PCT水平检测在老年AECOPD患者下呼吸道细菌感染中的诊断价值。结果:60例AECOPD患者下呼吸道感染33例,其中细菌感染25例,占75.76%(革兰阴性菌感染20例,占60.61%,革兰阳性菌感染5例,占15.15%);真菌感染8例,占24.24%;细菌组CRP、SAA、PCT水平均高于真菌组、阴性对照组,且真菌组高于阴性对照组,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,血清CRP、SAA、PCT水平检测诊断老年AECOPD患者下呼吸道细菌感染的AUC分别为0.925、0.875、0.935,均具有较高的诊断价值,且PCT>CRP>SAA。结论:血清CRP、SAA、PCT水平检测在老年AECOPD患者下呼吸道细菌感染诊断中具有较高的应用价值。

Objective:To analyze diagnostic value of serum C-reactive protein(CRP),amyloid protein(SAA)and procalcitonin(PCT)levels detection in lower respiratory tract bacterial infection in elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A prospective study was conducted on 60 elderly patients with AECOPD admitted to the hospital from February 2019 to May 2021.The lower respiratory tract infection was statistically analyzed,and these patients were divided into bacterial group,fungal group and negative control group according to the results of sputum culture.The levels of serum CRP,SAA and PCT were compared among the three groups.The receiver operating characteristic(ROC)curve was drawn.The area under the curve(AUC)was calculated.The diagnostic value of serum CRP,SAA and PCT levels detection in lower respiratory tract bacterial infection in the elderly patients with AECOPD was analyzed.Results:There were 33 cases of lower respiratory tract infection in the 60 AECOPD patients,including 25 cases of bacterial infection,accounting for 75.76%(20 cases of Gram negative bacteria infection,accounting for 60.61%,5 cases of Gram positive bacteria infection,accounting for 15.15%);and 8 cases of fungal infection,accounting for 24.24%.The levels of CRP,SAA,and PCT in the bacterial group were higher than those in the fungal group and the negative control group,those of the fungal group were higher than those of the negative control group,and the differences were statistically significant(P<0.05).The receiver operating characteristic curve showed that the areas under the curve(AUC)of the serum CRP,SAA,and PCT levels in the diagnosis of lower respiratory tract bacterial infection in the elderly AECOPD patients were 0.925,0.875,and 0.935,separately,they all had high diagnostic value(PCT>CRP>SAA).Conclusions:The detection of serum CRP,SAA,and PCT levels has high application value in the diagnosis of lower respiratory tract bacterial infection in the elderly AECOPD patients.