降钙素原在诊断社区获得性肺炎和指导抗生素应用中的价值

发布时间：2018-06-12 15:06

本文选题：社区获得性肺炎 + 降钙素原　；参考：《实用医学杂志》2014年20期

【摘要】：目的 :探讨降钙素原(PCT)在诊断社区获得性肺炎(CAP)和指导抗生素应用中的价值。方法:回顾性分析2013年5月至2014年5月收住我院呼吸科的CAP患者296例,同期收住的其他患者221例,比较PCT在CAP和非CAP患者之间、老年和非老年CAP之间的差异,作ROC曲线,运用最大约登指数法确定PCT诊断CAP的最佳临界值及相应的灵敏度(SEN)和特异度(SPE)。结果 :CAP患者PCT显著高于非CAP患者(P0.05)。PCT诊断CAP的ROC曲线下面积(AUC)是0.67,最佳临界值是0.055 ng/m L,对应的SEN和SPE分别是0.55和0.77。老年CAP患者PCT水平低于非老年CAP患者。PCT诊断老年CAP的AUC是0.63,最佳临界值是0.55 ng/m L,对应的SEN和SPE分别是0.53和0.73。PCT诊断非老年CAP的AUC是0.73,最佳临界值是0.085 ng/m L,对应的SEN和SPE分别是0.53和0.90。PCT指导抗生素应用与临床结合影像学指导抗生素应用比较疗程更短(P0.05),而疾病复发率无差异(P0.05)。结论:PCT在诊断CAP和指导抗生素应用中具有较高价值。
[Abstract]:Objective: to evaluate the value of procalcitonin (PCT) in the diagnosis of community-acquired pneumonia (CPAP) and the application of antibiotics. Methods: from May 2013 to May 2014, 296 CAP patients in our hospital and 221 other patients in the same period were analyzed retrospectively. The difference of PCT between CAP patients and non-CAP patients, aged and non-elderly CAP patients was compared and the ROC curve was made. The maximum Jordan index method was used to determine the optimal critical value and the corresponding sensitivity of PCT in the diagnosis of CAP. Results the area under ROC curve was 0.67 and the optimum critical value was 0.055 ng/m / L, and the corresponding SEN and SPE were 0.55 and 0.77, respectively. The level of PCT in elderly CAP patients is lower than that in non-elderly CAP patients. PCT is 0.63, the best critical value is 0.55 ng/m / L, the corresponding ng/m and SPE are 0.53 and 0.73.PCT for the diagnosis of non-senile CAP, the best critical value is 0.085 ng/m / L and the corresponding SEN is 0.73 ng/m / L, respectively. SPE and SPE were 0.53 and 0.90.PCT respectively. The course of treatment was shorter than that of clinical combined imaging guidance, but there was no difference in the recurrence rate of disease (P 0.05). ConclusionPCT has high value in diagnosing CAP and guiding antibiotic application.
【作者单位】：江苏省连云港市第一人民医院(徐州医学院附属连云港医院南京医科大学连云港临床医学院)呼吸科;
【基金】：国家自然科学基金(编号:81300052) 江苏省自然科学基金(编号:BK20130402)
【分类号】：R563.1

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