摘要
目的探讨血清PCT、CRP、WBC检测在老年社区获得性肺炎诊断及预后评估的临床价值。方法选择本院住院部2014年1月至2015年12月收治的112例老年社区获得性肺炎患者作为研究对象,设为研究组,同期入组56例门诊上呼吸道感染老年患者作为对照组,入院后24h内检测血清WBC、PCT、CRP浓度,同时进行肺炎严重程度CURB-65评分,根据肺炎严重程度分成重症CAP组与非重症CAP组,根据转归分为死亡组与好转组,比较研究组和对照组,重症组和非重症组,死亡组与好转组生化指标浓度差异,PCT≥0.5ng/ml,CRP〉10mg/L,WBC〉10×10^9 L^-1为阳性,分析PCT、CRP、WBC诊断的灵敏度、特异度。结果研究组PCT、CRP、WBC水平明显高于对照组,差异具有统计学意义,t=3.332、24.425、9.429,P〈0.05或P〈0.01。重症CAP组PCT、CRP、WBC水平明显高于非重症CAP组,差异具有统计学意义,t=3.441、12.084、4.966,P〈0.05或P〈0.01。死亡组PCT、CRP、WBC水平明显高于好转组,差异具有统计学意义,t=4.063、10.532、4.858,P〈0.01。CRP的灵敏度高于PCT、WBC,差异具有统计学意义,χ^2=4.265、5.041,均P〈0.05,PCT的特异度明显高于CRP、WBC,差异具有统计学意义,χ^2=8.166、10.530,均P〈0.01。结论血清PCT、CRP、WBC检测能够为老年社区获得性肺炎诊断提供有利信息,CRP灵敏度最高,PCT特异度最高,PCT、CRP浓度高低对于评估病情严重程度及疾病转归具有重要参考价值,二者水平越高,提示病情越严重,预后不佳。
Objective To investigate the clinical Value of diagnostic and prognostic assessment with PCT, CRP, WBC in Elderly Community-acquired Pneumonia. Methods 112 elderly patients with Community-acquired Pneumonia from January 2014 to December 2015 in our hospital were selected as research subjects for study groups, at the same time, 56 elderly patients with upper respiratory tract infection were selected as a control group, within 24 h after admission, the WBC, PCT, CRP were detected and the CURB-65 score were evaluated, all the patients were divided into severe CAP group and non-severe CAP group according to CURB-65 score, divided into death group and improved group, then the comparision of biochemical Indexes concentration were made between Study group and control group, severe group and non-severe group, death group and improved group, the Positive standard of PCT, CRP, WBC were respectively PCT≥0.5 ng/ml, CRP〉10 mg/L, WBC〉 10×10^9L^-1 ,then the Sensitivity, specificity of PCT, CRP, WBC were analyzed. Results The of PCT, CRP, WBC the study Group were significantly higher than the control group, the difference was statistically significant, t=3.332,24. 425,9. 429, P〈0. 05 or P〈0.01. the PCT, CRP, WBC of Severe CAP group were significantly higher than non-severe CAP group, the difference was statistically significant, t= 3. 441,12. 084,4. 966, P〈 0.05 or P〈0. 01. the PCT, CRP, WBC of death group were significantly higher than the improvement group, the difference was statistically significant, t=4. 063,10. 532,4. 858, P〈0. 01. the Sensitivity of CRP were higher than PCT,WBC, the difference was statistically significant,χ^2=4. 265,5. 041, both P〈0.05, the specificity of PCT was significantly higher than CRP, WEC, the difference was statistically significant, χ^2= 8. 166, 10. 530,are P〈0.01. Conclusion The detection of PCT,CRP,WBC can provide favorable information for the diagnosis of elderly Community-acquired Pneumonia, CRP has highest sensitivity, PCT has highest specificity, the PCT, CRP also has important reference value for the assessment of the disease severity and disease outcome, and the higher the level, the more severe the disease and poor prognosis.
出处
《中国实验诊断学》
2016年第6期922-924,共3页
Chinese Journal of Laboratory Diagnosis
关键词
社区获得性肺炎
老年
生化指标
诊断
预后
community-acquired pneumonia
biochemical indicators
elderly Diagnosis
Prognosis
