降钙素原、C反应蛋白和白细胞总数检测在医院获得性肺炎诊断中的应用价值

发布时间：2018-04-22 22:15

本文选题：降钙素原 + C反应蛋白　；参考：《广东医学》2017年S1期

【摘要】：目的探讨降钙素原(PCT)、C反应蛋白(CRP)和白细胞(WBC)总数检测在细菌引起的医院获得性肺炎(HAP)诊断中的应用价值,为其诊治提供参考。方法选择106例细菌性HAP患者作为研究对象,根据诊断标准分为重症HAP组和轻中症HAP组两个组。同时选择40例住院非感染者和40例健康体检者作为对照,分别检测血液中PCT、CRP和WBC总数,比较三者在重症HAP组、轻中症HAP组、住院非感染组和健康体检组间的差异,及对HAP诊断的敏感度和特异度,绘制ROC曲线,分析PCT、CRP和WBC在曲线下的面积(AUC)。结果重症HAP组PCT水平与轻中症HAP组比较差异有统计学意义(P0.01),重症HAP组和轻中症HAP组PCT水平与住院非感染组和健康体检组比较差异有统计学意义(P0.01);重症HAP组CRP水平与轻中症HAP组比较差异无统计学意义(P0.05),但二者均与住院非感染组和健康体检组比较差异有统计学意义(P0.01);轻中症HAP组和重症HAP组WBC分别与住院非感染组和健康体检组比较差异有统计学意义(P0.01),轻中症HAP与重症HAP组比较差异有统计学意义(P0.05);PCT、CRP、WBC在健康体检组与住院非感染组间比较差异无统计学意义(P0.05)。用于诊断HAP时,PCT敏感度和特异度分别达到96.23%和95.00%;CRP分别为92.45%和87.50%;WBC分别为83.02%和80.00%,三者的AUC分别为0.995、0.978、0.815。结论 PCT可鉴别重症肺炎和轻中症肺炎感染,可作为单独诊断细菌引起的HAP的敏感指标,而CRP及WBC可能辅助诊断,PCT在HAP诊断中价值大于CRP和WBC。
[Abstract]:Objective to evaluate the clinical value of the detection of the total number of procalcitonin (PCT) -C reactive protein (CRP) and leukocyte count (WBC) in the diagnosis of bacterial nosocomial pneumonia (HAP). Methods 106 patients with bacterial HAP were divided into two groups according to the diagnostic criteria: severe HAP group and mild moderate HAP group. At the same time, 40 non-infected patients in hospital and 40 healthy people were selected as control group. The blood levels of PCTV-CRP and WBC were measured respectively. The differences among the three groups were compared among severe HAP group, mild and moderate HAP group, non-infection group and healthy physical examination group. The sensitivity and specificity of HAP diagnosis were analyzed by drawing ROC curve and analyzing the area of WBC and WBC under the curve. Results the level of PCT in severe HAP group was significantly higher than that in mild HAP group (P 0.01), the PCT level in severe HAP group and mild moderate disease HAP group was significantly higher than that in hospitalized non infection group and healthy control group, and the CRP level in severe HAP group was significantly higher than that in non infection group and healthy control group, and the CRP level in severe HAP group was significantly higher than that in non infection group and healthy control group. There was no significant difference between mild and moderate HAP group (P 0.05), but there was a significant difference between the two groups compared with non-infection group and healthy physical examination group (P 0.01), WBC in mild moderate disease group (HAP group) and severe HAP group (WBC group) and non-infection group (non-infection group) and health examination group (P < 0.05). There was significant difference between mild and moderate HAP group and severe HAP group (P 0.05). There was no significant difference between healthy control group and non-infection group (P 0.05). The sensitivity and specificity of HAP were 96.23% and 95.00%, respectively, and the AUC of the three groups were 92.45% and 87.50%, 83.02% and 80.005%, respectively. Conclusion PCT can differentiate severe pneumonia from mild pneumonia infection and can be used as a sensitive index for the diagnosis of HAP caused by bacteria alone. CRP and WBC may be more valuable in the diagnosis of HAP than CRP and WBC.
【作者单位】：广州市花都区人民医院检验科;
【分类号】：R563.1

【相似文献】