PCT等多项指标联合检测在老年患者急性呼吸道感染中的应用

Combined detection of procalcitonin and other indicators in elderly patients with acute respiratory infection

目的评价联合检测降钙素原(PCT)、C反应蛋白(CRP)、前清蛋白(PA)水平在老年患者急性呼吸道感染中的临床意义。方法检测110例急性呼吸道感染老年患者及40例健康体检老年人(对照组)血清PCT、CRP、PA水平。比较各组研究对象血清PCT、CRP、PA水平的差异。将110例急性呼吸道感染老年患者根据病原学分型检查和疗效分为细菌感染组(40例)、病毒感染组(34例)和混合感染组(36例)。结果治疗前细菌感染组和混合感染组患者PCT、CRP水平明显高于对照组,PA水平明显低于对照组,差异均有统计学意义(P<0.05);病毒感染组患者各指标与对照组比较差异均无统计学意义(P>0.05);治疗后上述各指标与对照组比较差异均无统计学意义(P>0.05)。3项指标联合检测急性呼吸道感染的灵敏度、特异性、准确度、阳性预约值、阴性预约值及约登指数均高于单项检测。结论 PCT、CRP、PA可作为老年患者急性呼吸道感染的诊断指标,3项指标联合检测可提高老年患者急性呼吸道感染早期鉴别诊断的准确性,对疗效的判断具有较好的临床价值。

Objective To investigate the utility of combined detection of procalcitonin(PCT),C-reactive protein(CRP)and prealbumin(PA)in elderly patients with acute respiratory infectious diseases.Methods Detected the serum procalcitonin(PCT),C-reactive protein(CRP)and prealbumin(PA)of 110 elderly patients with acute respiratory infectious diseases and 40 healthy people during the same period as control group.The levels of PCT and CRP and PA among groups were compared before and after treatment.The 110 elderly patients with acute respiratory infections were divided into into bacterial infection group(n=40),virus infected group(n=34)and mixed infection group(n=36)according to the pathogen type.Results Before treatment,the PCT and CRP of bacterial infection group and mixed infection group were significantly higher than that of control group,while the level of PA was lower,and the difference were statistically significant(P<0.01).When Viral infection group compared with the control group,all the indicators showed no significant difference(P>0.05).After treatment,there was no significant difference.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and Youden′s index of combined detection of the three indicators were higher than those of single detection in acute respiratory infection.Conclusion PCT,CRP and PA can be used as the diagnostic indexes for elderly patients with acute respiratory tract infection.The combined detection of the 3indexes can improve the accuracy of early diagnosis of acute respiratory tract infections in elderly patients and can be used in therapeutic efficiency evaluation.