超敏C反应蛋白、前清蛋白及降钙素原在重症肺炎患者中的变化及诊断的临床意义(1)
摘 要：目的 探讨血清超敏C反应蛋白、前清蛋白及降钙素原联合检测在重症肺炎患者中的变化及诊断的临床意义。方法 选取2017年6月～2018年5月我院呼吸内科收治的肺炎患者70例作为研究对象，依据病情分为重症肺炎组与非重症肺炎组，同时选取30例健康体检者作为对照组，对比各组血清hc-CRP、PA及PCT结果并进行分析。结果 重症肺炎组血清hc-CRP及PCT水平分别为(15.44±1.76)mg/L、(0.92±0.22)ng/ml，高于非重症肺炎组(9.24±1.14)mg/L、(0.67±0.15)g/ml和对照组(2.66±0.26)mg/L、(0.16±0.02)g/ml(P<0.05)，血清PA(87.62±6.74)mg/L低于非重症肺炎组(165.49±21.26)mg/L和对照组(297.54±34.63)mg/L(P<0.05)，非重症肺炎组与对照组相比，血清hc-CRP、PA及PCT差异具有统计学意义(P<0.05);PCT敏感度最高，PA特异性最高，三项联合检测阳性率高于单项检测。结论 hc-CRP、PA及PCT对于重症肺炎诊断均有一定的临床诊断及鉴别诊断意义，并且三项联合检测可提高敏感度和特异性。
, 百拇医药
关键词：重症肺炎;超敏C反应蛋白;前清蛋白;降钙素原
中图分类号：R563.1;R446.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.022
文章编号：1006-1959(2018)24-0084-03
Abstract：Objective To investigate the clinical significance of serum hypersensitive C-reactive protein， prealbumin and procalcitonin in the diagnosis of severe pneumonia.Methods 70 patients with pneumonia admitted to our hospital from June 2017 to May 2018 were selected as subjects. According to the condition， they were divided into severe pneumonia group and non-severe pneumonia group. 30 healthy subjects were selected as the control group. Serum hc-CRP， PA and PCT results were analyzed and analyzed.Results The serum hc-CRP and PCT levels in severe pneumonia group were (15.44±1.76) mg/l， (0.92±0.22) ng/ml， higher than those in non-severe pneumonia group which were(9.24±1.14) mg/L，(0.67 ±0.15) g/ml respectively and (2.66±0.26) mg/l，(0.16±0.02) g/ml in control group (P<0.05).Serum PA (87.62±6.74) mg/L was lower than that in non-severe pneumonia group (165.49±21.26) mg/l and control group (297.54±34.63) mg/L(P<0.05).Compared with the control group， the serum hc-CRP，PA and PCT in the non-severe pneumonia group were significantly different(P<0.05).The sensitivity of PCT was the highest， the specificity of PA was the highest， and the positive rate of three combined tests was higher than that of single test.Conclusion Both hc-CRP，PA and PCT have some clinical and differential diagnostic significance in the diagnosis of severe pneumonia， and the combined detection can improve the sensitivity and specificity.
, 百拇医药
Key words：Severe pneumonia;Hypersensitive C-reactive protein;Prealbumin;Procalcitonin
重癥肺炎(severe pneumonia)是指有严重中毒症状或并发症的肺炎，其病原体感染比较复杂，临床症状不典型且发展迅速而难以鉴别，临床病死率较高。因此，快速准确对其感染早期进行诊断﹑预后判断及治疗至关重要[1]。目前对肺炎的实验室检查主要参考血常规白细胞总数、分类及相关炎症指标如C反应蛋白(hc-CRP)，但重症肺炎临床症状隐蔽，需要联合多项指标进行诊断。hc-CRP是常用的炎症反应早期指标，前清蛋白(PA)是负急性时相反应蛋白，降钙素原(PCT)是严重细菌性炎症与真菌感染的特异度指标，三项在重症肺炎的研究较少，本研究主要探讨血清hc-CRP、PA及PCT在重症肺炎患者水平变化，为临床诊断与治疗提供参考依据。, 百拇医药(付云杰)
, 百拇医药
关键词：重症肺炎;超敏C反应蛋白;前清蛋白;降钙素原
中图分类号：R563.1;R446.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.022
文章编号：1006-1959(2018)24-0084-03
Abstract：Objective To investigate the clinical significance of serum hypersensitive C-reactive protein， prealbumin and procalcitonin in the diagnosis of severe pneumonia.Methods 70 patients with pneumonia admitted to our hospital from June 2017 to May 2018 were selected as subjects. According to the condition， they were divided into severe pneumonia group and non-severe pneumonia group. 30 healthy subjects were selected as the control group. Serum hc-CRP， PA and PCT results were analyzed and analyzed.Results The serum hc-CRP and PCT levels in severe pneumonia group were (15.44±1.76) mg/l， (0.92±0.22) ng/ml， higher than those in non-severe pneumonia group which were(9.24±1.14) mg/L，(0.67 ±0.15) g/ml respectively and (2.66±0.26) mg/l，(0.16±0.02) g/ml in control group (P<0.05).Serum PA (87.62±6.74) mg/L was lower than that in non-severe pneumonia group (165.49±21.26) mg/l and control group (297.54±34.63) mg/L(P<0.05).Compared with the control group， the serum hc-CRP，PA and PCT in the non-severe pneumonia group were significantly different(P<0.05).The sensitivity of PCT was the highest， the specificity of PA was the highest， and the positive rate of three combined tests was higher than that of single test.Conclusion Both hc-CRP，PA and PCT have some clinical and differential diagnostic significance in the diagnosis of severe pneumonia， and the combined detection can improve the sensitivity and specificity.
, 百拇医药
Key words：Severe pneumonia;Hypersensitive C-reactive protein;Prealbumin;Procalcitonin
重癥肺炎(severe pneumonia)是指有严重中毒症状或并发症的肺炎，其病原体感染比较复杂，临床症状不典型且发展迅速而难以鉴别，临床病死率较高。因此，快速准确对其感染早期进行诊断﹑预后判断及治疗至关重要[1]。目前对肺炎的实验室检查主要参考血常规白细胞总数、分类及相关炎症指标如C反应蛋白(hc-CRP)，但重症肺炎临床症状隐蔽，需要联合多项指标进行诊断。hc-CRP是常用的炎症反应早期指标，前清蛋白(PA)是负急性时相反应蛋白，降钙素原(PCT)是严重细菌性炎症与真菌感染的特异度指标，三项在重症肺炎的研究较少，本研究主要探讨血清hc-CRP、PA及PCT在重症肺炎患者水平变化，为临床诊断与治疗提供参考依据。, 百拇医药(付云杰)