和肽素对社区获得性肺炎诊断价值及病情评估的探讨

发布时间：2018-03-25 13:12

  本文选题：和肽素　切入点：社区获得性肺炎　出处：《大连医科大学》2013年硕士论文

【摘要】：目的：探讨和肽素（copeptin，CPP）对社区获得性肺炎(community acquiredpneumonia，CAP)诊断的临床价值及病情严重程度的评估。 方法：本实验选取CAP患者55例，以结缔组织病相关间质性肺疾病（connectivetissue disease complicated with interstitial lung disease，CTD-ILD）患者20例、健康成人15例为对照。根据PSI评分，CAP分为低危组（0-90分）30例、中危组（91-130分）11例、高危组（130分）14例；根据CURB-65评分，分为低危组（O-1分或者无毒血症）41例、中危组（2分，合并毒血症）6例、高危组（3-5分，，合并严重毒血症或者感染性休克）8例；根据ATS成人CAP重症肺炎标准分为重症肺炎组（15例）和非重症肺炎组（40例）。采用ELISA法定量检测血清CPP水平，自动生化仪测定血清C反应蛋白（c-reactive protein，CRP）水平，双抗体夹心免疫发光法测定血清降钙素原（procalcitonin，PCT）水平。采用SPSS17.0统计软件分析，P0.05为差异有统计学意义。 结果： 1.CAP组及痰菌阳性CAP组血清CPP、CRP、PCT水平均明显高于健康对照组，差异有统计学意义（P0.05）；CAP组及痰菌阳性CAP组与CTD-ILD组比较，CPP、PCT均明显增高，差异有统计学意义（P0.05）。 2.PSI及CURB-65分级低危、中危、高危三组各生物标志物水平比较，血清CPP水平高危组均高于低危组及中危组，差异有统计学意义（P0.05）；血清PCT水平高危组高于中危组，差异有统计学意义（P0.05）；血清CRP水平在PSI分级的中危组高于低危组，差异有统计学意义（P0.05）。ATS重症肺炎组血清CPP水平明显高于非重症肺炎组，差异有统计学意义（P0.05），CRP及PCT在两组间比较差异均无统计学意义（P0.05）。 3.CAP组各生物学标志物水平与PSI、CURB-65评分的相关性分析，CPP水平与PSI评分、CURB-65评分均存在正相关，差异有统计学意义（P0.05）；CRP、PCT水平与PSI评分、CURB-65评分均无相关性，差异无统计学意义（P0.05）。 结论： 1.血清CPP水平对CAP的诊断具有一定的临床价值。 2.血清CPP水平随着肺炎程度的加重而明显增加，其水平能够反映CAP患者的病情严重程度。
[Abstract]:Objective: To evaluate the clinical value and severity of copeptin (CPP) in the diagnosis of community acquired pneumonia (community acquiredpneumonia (CAP)).
Methods: This study selected 55 cases of CAP patients with connective tissue disease related interstitial lung disease (connectivetissue disease complicated with interstitial lung disease, CTD-ILD) in 20 patients and 15 healthy adults as control. According to the PSI score, CAP divided into low risk group (0-90) in 30 cases, medium risk group (91-130 points) 11 cases of high-risk group, 14 cases (130); according to the CURB-65 score, divided into low risk group (O-1 or non-toxic HLP) in 41 cases, medium risk group (2 points, 6 cases with sepsis), high risk group (3-5 points, with severe sepsis or septic shock) 8 cases; according to the ATS adult CAP standard of severe pneumonia were divided into the severe pneumonia group (15 cases) and non severe pneumonia group (40 cases). ELISA method was used for quantitative detection of serum CPP level, serum C reactive protein determination of automatic biochemical analyzer (C-reactive protein, CRP), double antibody sandwich immunoassay for determination of serum procalcitonin (procalcitonin water, PCT) SPSS17.0 statistical software analysis showed that P0.05 was statistically significant.
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