全科医学临床与教育
全科醫學臨床與教育
전과의학림상여교육
CLINICAL EDUCATION OF GENERAL PRACTICE
2014年
2期
138-141
,共4页
社区获得性肺炎%降钙素原%C反应蛋白%诊断价值
社區穫得性肺炎%降鈣素原%C反應蛋白%診斷價值
사구획득성폐염%강개소원%C반응단백%진단개치
community-acquired pneumonia%serum procalcitonin%C-reactive protein%diagnosis value
目的：探讨血清降钙素原（PCT）及C反应蛋白（CRP）在社区获得性肺炎（CAP）中的诊断价值。方法回顾性分析明确诊断为肺部疾病的患者122例，分为细菌感染组54例和非细菌感染组68例，并根据重症肺炎诊断标准，将细菌感染组分为重症肺炎18例，轻中症肺炎36例。记录并比较所有患者入院24 h内的血常规、PCT、CRP、病原学等指标，并描绘ROC曲线进行分析。结果 PCT及CRP在CAP患者中的水平高于非细菌感染的患者（t分别=3.62、7.25，P＜0.05）。重症组的PCT和CRP水平明显高于轻中症组（t分别=2.37、2.65，P均＜0.05）。 ROC曲线分析显示，所有患者PCT和CRP的ROC曲线下面积分别为0.89和0.88，PCT和CRP诊断CAP细菌感染的最佳诊断阈值分别为0.09μg/L、29.27 mg/L。重症细菌感染组PCT和CRP的ROC曲线下面积分别为0.80和0.74，PCT和CRP诊断重症细菌感染的最佳诊断阈值分别为0.17μg/L、85.17 mg/L，此时PCT、CRP的灵敏度分别为88.89%、66.67%，特异度分别为66.65%、80.55%，PCT对重症细菌感染具有高度灵敏度，在重症细菌感染中的敏感性较CRP高，特异性未见明显优势。结论CAP患者的PCT及CRP水平较非细菌感染肺疾病患者高；PCT联合CRP对诊断细菌性肺炎及重症细菌感染性肺炎具有更高的特异性，有助于提高诊断的准确性。
目的：探討血清降鈣素原（PCT）及C反應蛋白（CRP）在社區穫得性肺炎（CAP）中的診斷價值。方法迴顧性分析明確診斷為肺部疾病的患者122例，分為細菌感染組54例和非細菌感染組68例，併根據重癥肺炎診斷標準，將細菌感染組分為重癥肺炎18例，輕中癥肺炎36例。記錄併比較所有患者入院24 h內的血常規、PCT、CRP、病原學等指標，併描繪ROC麯線進行分析。結果 PCT及CRP在CAP患者中的水平高于非細菌感染的患者（t分彆=3.62、7.25，P＜0.05）。重癥組的PCT和CRP水平明顯高于輕中癥組（t分彆=2.37、2.65，P均＜0.05）。 ROC麯線分析顯示，所有患者PCT和CRP的ROC麯線下麵積分彆為0.89和0.88，PCT和CRP診斷CAP細菌感染的最佳診斷閾值分彆為0.09μg/L、29.27 mg/L。重癥細菌感染組PCT和CRP的ROC麯線下麵積分彆為0.80和0.74，PCT和CRP診斷重癥細菌感染的最佳診斷閾值分彆為0.17μg/L、85.17 mg/L，此時PCT、CRP的靈敏度分彆為88.89%、66.67%，特異度分彆為66.65%、80.55%，PCT對重癥細菌感染具有高度靈敏度，在重癥細菌感染中的敏感性較CRP高，特異性未見明顯優勢。結論CAP患者的PCT及CRP水平較非細菌感染肺疾病患者高；PCT聯閤CRP對診斷細菌性肺炎及重癥細菌感染性肺炎具有更高的特異性，有助于提高診斷的準確性。
목적：탐토혈청강개소원（PCT）급C반응단백（CRP）재사구획득성폐염（CAP）중적진단개치。방법회고성분석명학진단위폐부질병적환자122례，분위세균감염조54례화비세균감염조68례，병근거중증폐염진단표준，장세균감염조분위중증폐염18례，경중증폐염36례。기록병비교소유환자입원24 h내적혈상규、PCT、CRP、병원학등지표，병묘회ROC곡선진행분석。결과 PCT급CRP재CAP환자중적수평고우비세균감염적환자（t분별=3.62、7.25，P＜0.05）。중증조적PCT화CRP수평명현고우경중증조（t분별=2.37、2.65，P균＜0.05）。 ROC곡선분석현시，소유환자PCT화CRP적ROC곡선하면적분별위0.89화0.88，PCT화CRP진단CAP세균감염적최가진단역치분별위0.09μg/L、29.27 mg/L。중증세균감염조PCT화CRP적ROC곡선하면적분별위0.80화0.74，PCT화CRP진단중증세균감염적최가진단역치분별위0.17μg/L、85.17 mg/L，차시PCT、CRP적령민도분별위88.89%、66.67%，특이도분별위66.65%、80.55%，PCT대중증세균감염구유고도령민도，재중증세균감염중적민감성교CRP고，특이성미견명현우세。결론CAP환자적PCT급CRP수평교비세균감염폐질병환자고；PCT연합CRP대진단세균성폐염급중증세균감염성폐염구유경고적특이성，유조우제고진단적준학성。
Objective To explore the diagnosis value of serum procalcitonin (PCT) and C-reactive protein (CRP) in community-acquired pneumonia (CAP). Methods A total of 122 patients diagnosed as lung disease which of 54 patients with CAP and 68 patients with non-bacterial infection of lung disease were enrolled. According to the severe pneumonia diagnosis criteria,the bacterial infection group was divided into severe pneumonia and light and moderate pneumonia. Rou-tine bloods, PCT, CRP,etiology and other relevant indicators were recorded and compared. ROC curve were described and analyzed. Results The PCT and CRP in patients with CAP were significantly higher than those in patients with non-bac-terial infection(t=3.62, 7.25,P<0.05). The PCT and CRP in severe groups were significantly higher than those in the light and moderate groups (t=2.37,2.65,P<0.05). ROC curve analysis showed that the areas of PCT and CRP under the ROC curve in all patients were 0.89 and 0.88 respectively. The best diagnostic threshold of PCT and CRP were 0.09 μg/L and 29.27mg/L respectively. The areas of PCT and CRP under the ROC curve in patients with CAP were 0.80 and 0.74 respec-tively. The best diagnostic threshold of PCT and CRP were 0.17μg/L and 85.17mg/L respectively. At this point, the sensi-tivity of PCT and CRP were 88.89%and 66.67%, the specificity were 66.65%and 80.55%. PCT had high sensitivity to the severe bacterial infection. For severe bacterial infection, PCT had higher sensitivity than CRP while its specificity had no obvious difference. Conclusions PCT and CRP in patients with CAP were higher than those in patients with non-bacterial infection of pulmonary disease. Combined PCT with CRP has a higher specificity in diagnosis of bacterial pneumonia and severe bacterial infection, which is helpful to improve the accuracy of diagnosis.
