摘要
目的探讨血清降钙素原(PCT)检测对老年人细菌性肺炎与肺癌的鉴别诊断价值,以及在指导用药中的价值。方法随机选择2014年1月至2015年9月该院呼吸内科、胸外科收治的细菌性肺炎老年患者50例和肺癌老年患者40例,以及100例健康对照者作为研究对象,采用化学发光免疫分析法(CLIA)检测血清PCT水平,同时规范采集晨痰标本进行痰培养及药敏试验;对50例细菌性肺炎患者选用二代或三代头孢菌素治疗7d后再次检测血清PCT。结果细菌性肺炎组治疗前、细菌性肺炎组治疗7d后及肺癌组患者血清PCT水平分别为(9.960±8.540)、(2.420±1.280)、(0.346±0.300)ng/mL,均明显高于健康对照组的(0.027±0.010)ng/mL(P<0.05)。细菌性肺炎组治疗前与肺癌组比较,血清PCT水平明显升高,差异有统计学意义(P<0.05),细菌性肺炎组患者治疗7d后与治疗前比较,血清PCT水平明显降低,差异有统计学意义(P<0.05)。50例细菌性肺炎患者痰培养阳性21例,阳性率为42.0%,这21例痰培养阳性的细菌性肺炎患者治疗前血清PCT水平明显升高,为(17.620±8.460)ng/mL。药敏试验显示,分离出的1株铜绿假单胞菌为多重耐药菌,对头孢菌素类药物耐药。结论血清PCT检测对老年人细菌性肺炎与肺癌具有一定的鉴别诊断价值;联合血清PCT及病原学检测对指导临床抗菌药物合理使用具有重要价值。
Objective To study differential diagnosis value and practiced value of conducting using antibiotics of serum procalcitonin（PCT）levels among old people with bacterial pneumonia and lung neoplasm.Methods From January 2014 to September 2015,a total of 50 patients with bacterial pneumonia,40 patients with lung neoplasm,and 100 healthy person were collected in this study,all the subjects were 60 or more than 60 years old.Chemiluminescence Immune Assay（CLIA）method was used to detect concentrations of serum PCT.Meanwhile morning sputum samples were collected and cultured,then did drug sensitive test.50 patients with bacterial pneumonia were treated with second or third generation of cephalosporin antibiotics in 7days,and then detected PCT.Results Serum PCT level in the bacterial pneumonia group before treatment,after treating 7days,lung neoplasm group were（9.960±8.540）,（2.420±1.280）and（0.346±0.300）ng/mL,which were all significant higher than（0.027±0.010）ng/mL in the control group,the differences were statistical significant（P〈0.05）.Serum PCT level in the bacterial pneumonia group before treatment was significant higher than that of lung neoplasm group（P〈0.05）.The serum PCT level of patients after treating 7days decreased significantly comparing with before treatment（P〈0.05）.A total of 21 cases in 50 patients with bacterial pneumonia had positive sputum culture result,the positive rate was 42.0%.The serum PCT level of 21 patients with positive sputum culture result before treatment was（17.620±8.460）ng/mL,which increased significantly.Drug sensitive test showed one strain of pseudomonas aeruginosa isolated was multiple drug-resistant bacteria,which was resistant to the cephalosporin.Conclusion Detecting PCT has value on differential diagnosis between bacterial pneumonia and lung neoplasm among old people,combining with drug sensitive test is important for conducting the use of antibiotics.
作者
张德文
何倩
龙林会
ZHANG Dewen HE Qian LONG Linhui(Department of Clinical Laboratory, the Third People＇s Hospital of Zigong, Zigong, Sichuan 643020, Chin)
出处
《检验医学与临床》
CAS
2016年第19期2728-2729,共2页
Laboratory Medicine and Clinic
基金
四川省预防医学会资助项目(2013GK-24)
关键词
降钙素原
细菌性肺炎
肺癌
抗菌药物
procalcitonin
bacterial pneumonia
lung neoplasm
antibiotics
