血清降钙素原对急性左心衰竭患者社区获得性肺炎的临床诊断研究

发布时间：2018-10-20 16:08

【摘要】：目的探讨血清降钙素原(PCT)对急性左心衰竭并发社区获得性肺炎患者的临床价值。方法从2014年1月-2017年2月到医院就诊的急性左心衰竭的患者中选择106例,其中合并社区获得性肺炎者56例,未合并肺炎者50例,并将其分为研究组和对照组。比较两组患者动态血清PCT、C-反应蛋白(CRP)变化,血清PCT浓度水平与肺炎严重程度、抗菌药物使用时间、住院时间的关系,并将研究组分为细菌感染组29例和非细菌感染组27例,观察两组患者之间血清PCT浓度水平。结果研究组不同时间段血清PCT浓度均比对照组高,差异有统计学意义(P0.05);以血清PCT0.05μg/L为阳性标准诊断急性左心衰竭合并社区获得性肺炎的敏感性为91.07%,特异性为88.00%;患者血清PCT浓度水平与患者肺炎严重程度呈正相关,抗菌药物运用时间和住院时间也随血清PCT浓度水平增长而延长;以血清PCT2.0μg/L为阳性标准诊断急性左心衰竭合并肺部细菌感染的敏感性为75.86%,特异性为70.37%。结论血清PCT在诊断急性左心衰竭合并社区获得性肺炎和判断患者肺炎严重程度中起着重要的作用,并可以估计患者肺部感染的病原体类型。
[Abstract]:Objective to investigate the clinical value of serum procalcitonin (PCT) in patients with acute left heart failure complicated with community-acquired pneumonia. Methods from January 2014 to February 2017, 106 patients with acute left ventricular failure were selected, including 56 patients with community-acquired pneumonia and 50 patients without pneumonia. The patients were divided into study group and control group. The changes of dynamic serum PCT,C- reactive protein (PCT,C-) (CRP), the relationship between serum PCT concentration and severity of pneumonia, duration of antibiotic use, and hospitalization time were compared between the two groups. The study group was divided into two groups: bacterial infection group (n = 29) and non-bacterial infection group (n = 27). Serum PCT levels were observed between the two groups. Results the concentration of serum PCT in the study group was higher than that in the control group. The sensitivity and specificity of serum PCT0.05 渭 g / L in the diagnosis of acute left heart failure complicated with community-acquired pneumonia were 91.07 and 88.00.The serum PCT level was positively correlated with the severity of pneumonia. The application time and hospitalization time of antimicrobial agents also prolonged with the increase of serum PCT concentration, and the sensitivity and specificity of serum PCT2.0 渭 g / L for the diagnosis of acute left heart failure with pulmonary bacterial infection were 75.86 and 70.37 respectively. Conclusion Serum PCT plays an important role in the diagnosis of acute left heart failure complicated with community-acquired pneumonia and the severity of pneumonia.
【作者单位】：海南医学院第二附属医院东湖急诊科;
【基金】：海南省卫生厅科研立项课题(琼卫2013资助-025号)
【分类号】：R541.6;R563.1

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