C-反应蛋白测定对社区获得性肺炎的诊断价值

Diagnostic Value of C-reactive Protein Measurement in Community Acquired Pneumonia

目的 探讨血清C -反应蛋白 (CRP)测定对社区获得性肺炎 (CAP)的诊断价值。方法 将 70例CAP患者按血白细胞(WBC)计数 10 0× 10 9/L为界分为A、B两组 ,另设 80例上呼吸道感染患者为对照组 (C组 ) ,采用金标定量检测法测定血清CRP含量。结果 血CRP含量 :A组 [( 12 3 71± 5 6 95 )mg/L]、B组 [( 96 2 8± 45 0 9)mg/L]显著高于C组 [( 11 40± 3 71mg/L) ] ,P <0 0 1,而A组又高于B组 ,P <0 0 1。血WBC计数 :A组 [( 13 . 72± 4 13 )× 10 9/L]高于B组 [( 7 17± 1 3 7)× 10 9/L] ,P <0 0 1,B组与C组[( 6 3 6± 1 61)× 10 9/L) ]无显著差异 ,P >0 0 5。分别将血CRP含量≥ 2 5mg/L、血WBC≥ 10 0× 10 9/L和血中性粒细胞比例≥ 80 %定为CAP诊断阳性标准 ,则敏感性分别为 10 0 %、48 6%和 40 %,特异性分别为 95 %、92 5 %和 95 %。血CRP对CAP诊断敏感性高于血WBC计数和中性粒细胞比例 ,P <0 0 1。结论 检测血CRP水平有助于CAP 。

Objective To investigate the diagnostic value of measurement of serum C-reactive protein(CRP) level in patients with community acquired pneumonia(CAP).Methods The CRP level were measured by the gold-labeled antibody in 70 patients with CAP. According to white blood cell count (10 0×10 9/L) , they were divided into two groups(group A,B).another 80 patients with acute upper respiratory tract infection were included as control group(group C).Results The CRP level of group A,B and C were 123 71±56 95mg/L,96 28±45 09mg/L and 11 40±3 71mg/L respectively. The CRP levels of group A and B were significantly higher than that of group C(P<0 01). And the CRP level of group A was also elevated as compared with that of group B(P<0 01).The WBC count of group A(13 72±4 13×10 9/L)was significantly higher than that of group B(7 17±1 37×10 9/L),P<0 01. And the WBC count of group B was not significantly difference with that of group C(6 36±1 61×10 9/L),P>0 05.According to diagnostic criteria of the CRP level ≥25mg/L, the WBC count ≥10 0×10 9/L and neutrophil proportion ≥80%, the sensitivities were 100%, 48.6% and 40%, the specificities were 95%, 92 5% and 95% respectively,for CAP diagnosis. The diagnostic sensitivity of the CRP level was significantly higher than that of the WBC count and neutrophil proportion for CAP(P<0 01).Conclusion The measurement of CRP level is helpful for diagnosing and evaluating the CRP.