血清炎性标记物在急性肺脓肿早期的鉴别诊断价值

Value of serum inflammatory markers in the early differential diagnosis of acute pulmonary abscess

目的:本研究拟通过观察急性肺脓肿患者血清降钙素原(PCT)、白细胞介素-6(IL-6)及C反应蛋白(CRP)情况,同时,对比肺结核及肺癌患者3种炎症指标水平,了解联合炎症指标检测在肺脓肿鉴别诊断中的价值。方法:分别采用电化学发光法、免疫比浊法对16例肺脓肿患者的血清PCT进行检测,同时应用全自动血细胞计数仪计数WBC。并与肺结核组、肺癌组和健康对照组比较。结果:肺脓肿患者血清PCT、CRP及IL-6的含量均高于健康对照组,差异有统计学意义(P<0.05)。肺结核组血清PCT及CRP水平高于肺癌组及健康对照组,差异有统计学意义(P<0.05),IL-6水平较肺癌组及健康对照组差异无统计学意义(P>0.05)。肺结核组血清PCT水平较肺脓肿组差异无统计学意义(P>0.05),CRP水平低于肺脓肿组,差异有统计学意义(P<0.05)。血清PCT水平与CRP水平之间呈正相关(r=0.54,P<0.01);血清PCT水平与IL-6水平之间呈正相关(r=0.65,P<0.01)。结论:联合PCT、CRP及IL-6检测可以成为肺脓肿鉴别诊断的依据,并为临床决定是否使用抗菌素提供参考价值。

Objective:This study observed serum procalcitonin(PCT),interleukin-6(IL-6) and C reactive protein(CRP) of patients with acute pulmonary abscess,at the same time,compared the three kinds of inflammation index of pulmonary tuberculosis and lung cancer patients to understand the value of combined detection of inflammatory markers in the differential diagnosis of pulmonary abscess.Methods:We detected the serum PCT of 16 cases of lung abscess respectively by electrochemiluminescence,immune turbidimetry,at the same time,we counted the WBC by automatic blood cell counter.Compare with the pulmonary tuberculosis group,the lung cancer group and the healthy control group.Results:The content of serum PCT,CRP and IL-6 of patients with acute pulmonary abscess were all higher than those in healthy control group(P<0.05).In the pulmonary tuberculosis group,the serum PCT and CRP levels were higher than the lung cancer group and the healthy control group(P<0.05).IL-6 level did not change significantly with lung cancer group and healthy control group(P>0.05).In the pulmonary tuberculosis group,the serum level of PCT had no significant changes compared with lung abscess group(P>0.05).The level of CRP was lower than the lung abscess group(P<0.05).There was a positive correlation between the level of serum PCT and CRP levels(r=0.54,P<0.01).There was a positive correlation between the level of serum PCT and IL-6 levels(r=0.65,P<0.01).Conclusion:The combined detection of PCT,CRP and IL-6 can be a basis for differential diagnosis of pulmonary abscess,and provides reference for with or without antibiotics.