血清炎性标志物在老年肺炎评估应用中的临床意义

发布时间：2018-11-13 12:52

【摘要】：目的:本论文旨在分析总结探讨血清炎症标志物C反应蛋白(CRP)、降钙素原(PCT)检测在老年肺炎诊治及预后评估中的临床意义及痰液性质与炎症标志物之间的关系,并结合中医中药理论探讨老年肺炎的诊治。方法:通过分析患者的入院时一般情况(年龄、性别、是否合并基础病)、临床表现、痰液性质、痰培养、CURB-65评分、血清C反应蛋白(CRP)、血清降钙素原(PCT)、血白细胞计数(WBC)、中医分型、预后(是否死亡),进而中西医结合总结老年肺炎的临床特征、中医症型、痰液性质与炎性标志物关系及炎性标志物在老年肺炎诊治及预后评估中的临床意义,提高老年肺炎的诊治水平。结果:1血清PCT与患者死亡预后相关性最高(r=0.396),且相关性有统计学意义(P=0.0000.05),血清CRP与患者死亡预后相关性次之(r=0.235),且相关性有统计学意义(P0.05),WBC与患者死亡预后相关性没有统计学意义(P0.05)。进一步研究PCT与患者死亡率关系中发现,阈值T=4.868ng/m L,也就是说当PCT=4.868ng/m L时或许可以预测患者死亡率。2黄痰组的痰培养细菌阳性率明显高于非黄痰组,黄痰组的CRP的平均数为82.984±62.233mg/L,非黄痰组CRP的平均数为29.161±35.447mg/L,有统计学意义(P=0.000
[Abstract]:Objective: to investigate the clinical significance of serum C-reactive protein (CRP), procalcitonin (PCT) in diagnosis, treatment and prognosis evaluation of senile pneumonia and the relationship between sputum properties and inflammatory markers. The diagnosis and treatment of senile pneumonia were discussed in combination with the theory of traditional Chinese medicine. Methods: by analyzing the general condition (age, sex, whether or not associated with basic disease), clinical manifestations, sputum properties, sputum culture, CURB-65 score, serum C-reactive protein (CRP), serum procalcitonin (PCT),. Blood leukocyte count (WBC), type, prognosis (death or not), and then integrated Chinese and Western medicine to summarize the clinical characteristics of pneumonia in the elderly, TCM symptomatic type, The relationship between sputum nature and inflammatory markers and the clinical significance of inflammatory markers in the diagnosis and treatment and prognosis evaluation of senile pneumonia and to improve the level of diagnosis and treatment of senile pneumonia. Results: (1) the correlation between serum PCT and mortality prognosis was the highest (r = 0.396), and the correlation was statistically significant (P < 0.05), and the correlation between serum CRP and mortality prognosis was second (r = 0.235). And the correlation was statistically significant (P0.05), WBC and mortality prognosis was not statistically significant (P0.05). Further study of the relationship between PCT and patient mortality found that threshold T=4.868ng/m L, that is, when PCT=4.868ng/m L may predict the death rate of patients with sputum, the positive rate of sputum culture bacteria in the yellow sputum group was significantly higher than that in the non-yellow sputum group. The average of CRP was 82.984 卤62.233 mg / L in the yellow phlegm group and 29.161 卤35.447 mg / L in the non-yellow phlegm group.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R563.1

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