CAJ | 학술논문

目的：通过测定典型病原菌及非典型病原菌致社区获得性肺炎（CAP）患者的血清降钙素原（PCT）水平，探讨其鉴别诊断的价值。方法回顾性分析222例CAP患者，根据病原菌的不同，分为典型病原菌组（139例）及非典型病原菌组（83例）两组，比较两组患者的PCT、CRP 及WBC，并绘制PCT和CRP的ROC曲线，根据曲线下面积评价其对上述两组病原菌所致CAP的鉴别诊断价值。结果典型病原菌组患者PCT水平为0.31 ng/ml（四分位数间距：0.10 ng/ml，2.58 ng/ml），明显高于非典型病原菌组0.17 ng/ml（四分位数间距：0.08 ng/ml，0.66 ng/ml）（P＜0.05）；且两组患者PCT的阳性率比较有统计学意义（0.96比0.67）（P＜0.05）。绘制PCT鉴别CAP病原菌的ROC曲线，曲线下面积（AUC）为0.783，在临界值为0.95 ng/ml时，其敏感度为0.932，特异度为0.894。结论血清PCT测定有助于CAP病原菌的鉴别诊断，可作为初始选择抗生素治疗的依据。
목적：통과측정전형병원균급비전형병원균치사구획득성폐염（CAP）환자적혈청강개소원（PCT）수평，탐토기감별진단적개치。방법회고성분석222례CAP환자，근거병원균적불동，분위전형병원균조（139례）급비전형병원균조（83례）량조，비교량조환자적PCT、CRP 급WBC，병회제PCT화CRP적ROC곡선，근거곡선하면적평개기대상술량조병원균소치CAP적감별진단개치。결과전형병원균조환자PCT수평위0.31 ng/ml（사분위수간거：0.10 ng/ml，2.58 ng/ml），명현고우비전형병원균조0.17 ng/ml（사분위수간거：0.08 ng/ml，0.66 ng/ml）（P＜0.05）；차량조환자PCT적양성솔비교유통계학의의（0.96비0.67）（P＜0.05）。회제PCT감별CAP병원균적ROC곡선，곡선하면적（AUC）위0.783，재림계치위0.95 ng/ml시，기민감도위0.932，특이도위0.894。결론혈청PCT측정유조우CAP병원균적감별진단，가작위초시선택항생소치료적의거。
Objective To study the differential value of serum procalcitonin (PCT) between typical and atypical community-acquired pneumonia(CAP). Methods The serum procalcitonin of patients with typical bacterial CAP (139 cases) and atypical bacterial CAP (83 cases) were retrospectively analyzed and compared with C-reactive protein (CRP), leukocyte count (WBC). ROC curves were described and the differential value of PCT and CRP were evaluated according to AUC. Results The level of PCT was significantly higher in patients with typical bacterial CAP than in patients with atypical bacterial CAP [0.31 ng/ml(Interquartile ranges: 0.10 ng/ml, 2.58 ng/ml) vs. 0.17 ng/ml(Interquartile ranges:0.08 ng/ml, 0.66 ng/ml), P<0.05];And the positive rate of PCT was statistically significant between the two groups, (0.96 vs. 0.67)(P<0.05) .The AUC of ROC curve was 0.783. At the cut-off value of 0.95 ng/ml, the sensitivity was 0.932 and the specificity was 0.894. Conclusion Serum procalcitonin contributes to differential diagnosis on the etiology of pneumonia and could have a crucial influence on the initial antimicrobial therapy.