炎症标记物对细菌感染性肺炎患者的病情进展与影像学分析及预后评估的研究

发布时间：2018-11-02 09:45

【摘要】：目的观察细菌感染性肺炎患者治疗前后炎症标记物超敏C-反应蛋白(hs-CRP)和降钙素原(PCT)的水平,分析患者病程进展期的影像学特征,评估其对患者的预后评估价值。方法前瞻性纳入2013年6月-2016年12月医院呼吸内科收治的120例细菌性肺炎患者,将患者分为死亡风险中等组65例和高等组55例;检测患者入院24h内及抗感染治疗第3天和第5天hs-CRP和PCT水平,并同步在放射科行胸部X片和CT检查。结果入院时高等组hs-CRP和PCT水平表达显著高于中等组(P0.05);随着治疗时间延长,中等组hs-CRP和PCT水平逐渐下降,高等组hs-CRP和PCT水平逐渐上升(P0.05);高等组进展期肺部炎症浸润程度与hsCRP和PCT的高表达正相关(P0.05);hs-CRP和PCT预测高风险患者死亡的曲线下面积依次为0.826和0.884(P0.05)。结论不同死亡风险的细菌性肺炎患者病程中可表现不同的影像学特征;检测hs-CRP和PCT有助于动态评估患者病情变化,并对预后进行早期预警。
[Abstract]:Objective to observe the levels of hyper-sensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) (PCT) in patients with bacterial infectious pneumonia before and after treatment, and to analyze the imaging features of the course of disease in order to evaluate their prognostic value. Methods 120 patients with bacterial pneumonia who were admitted to Department of Respiratory Medicine from June 2013 to December 2016 were divided into middle risk group (65 cases) and higher group (55 cases). The levels of hs-CRP and PCT were detected within 24 hours of admission and on the 3rd and 5th day of anti-infective therapy. Chest X-ray and CT were performed simultaneously in radiology department. Results the expression of hs-CRP and PCT in the higher group was significantly higher than that in the middle group on admission (P0.05), the hs-CRP and PCT levels in the middle group decreased gradually with the prolongation of the treatment time, and the hs-CRP and PCT levels increased gradually in the higher group (P0.05). In advanced group, the degree of pulmonary inflammatory infiltration was positively correlated with the high expression of hsCRP and PCT (P0.05), and the area under the curve of hs-CRP and PCT were 0.826 and 0.884 respectively (P0.05). Conclusion different imaging features can be observed in patients with bacterial pneumonia with different death risk, and the detection of hs-CRP and PCT is helpful for dynamic evaluation of disease changes and early warning of prognosis.
【作者单位】：浙江萧山医院放射科;浙江大学医学院附属第一医院放射科;浙江萧山医院检验科;
【基金】：浙江省医学会临床科研资金项目(2011zyc-B04)
【分类号】：R563.1

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