CAJ | 학술논문

目的：探讨降钙素原（ PCT ）对危重症患者呼吸机相关性肺炎（ VAP ）早期诊断与预后判断的价值。方法疑似危重症VAP患者82例，检测其白细胞计数、C-反应蛋白及PCT水平。根据确诊结果将82例患者分为确诊组42例与非确诊组40例，其中确诊组患者常规治疗5 d后再检测PCT，并进行临床肺部感染评分（CPIS），根据CPIS分为良好组22例与恶化组20例。对比确诊组与非确诊组、良好组与恶化组间PCT、C-反应蛋白水平及白细胞计数等相关指标。结果确诊组患者血清PCT、C-反应蛋白及白细胞计数水平均明显高于非确诊组（P＜0．05）。良好组患者血清PCT、C-反应蛋白水平、白细胞计数与CPIS分值均明显低于恶化组（P＜0．05）。结论 PCT对危重症VAP早期诊断有重要价值，动态监测PCT对于VAP预后判断有积极的意义。
목적：탐토강개소원（ PCT ）대위중증환자호흡궤상관성폐염（ VAP ）조기진단여예후판단적개치。방법의사위중증VAP환자82례，검측기백세포계수、C-반응단백급PCT수평。근거학진결과장82례환자분위학진조42례여비학진조40례，기중학진조환자상규치료5 d후재검측PCT，병진행림상폐부감염평분（CPIS），근거CPIS분위량호조22례여악화조20례。대비학진조여비학진조、량호조여악화조간PCT、C-반응단백수평급백세포계수등상관지표。결과학진조환자혈청PCT、C-반응단백급백세포계수수평균명현고우비학진조（P＜0．05）。량호조환자혈청PCT、C-반응단백수평、백세포계수여CPIS분치균명현저우악화조（P＜0．05）。결론 PCT대위중증VAP조기진단유중요개치，동태감측PCT대우VAP예후판단유적겁적의의。
Objective To study the value of procalcitonin ( PCT) for early diagnosis and prognostic judgment in critically patients with ventilator associated pneumonia .Methods Eighty-two critically patients with suspected ventilator associated pneumonia were detected for their WBC count,C-reactive protein(CRP) and PCT levels.Eighty-two patients were divided into diagnosis group (42 cases) and non-diagnosis group(40 cases) according the confirmed diagnostic results.The patients in the diagnosis group were detected for PCT after 5-day routine treatment ,and their clinical pulmonary infection scores(CPIS) were assessed.The patients in the diagnosis group were divided into recovery group (22 cases) and deterioration group (20 cases ) according to their CPIS scores .The related indexes including PCT , CRP levels and WBC count were compared between diagnosis group and non-diagnosis group as well as recovery group and deterioration group . Results The serum PCT ,CRP levels and WBC count in the diagnosis group were significantly higher than those in the non-diagnosis group(P<0.05).The serum PCT,CRP levels,WBC count and CPIS scores in the recovery group were significantly lower than those in the deterioration group (P<0.05).Conclusion PCT is valuable in the early diagnosis of critically patients with VAP ,and dynamically monitoring PCT plays an active role on judging the prognosis of VAP.