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(P<0.05);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(P<0.05);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(P<0.05);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(P<0.05)。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。
OBJECTIVE To observe the levels of inflammatory markers of hyper-sensitive C reactive protein（hsCRP）and procalcitonin（PCT）in patients with bacterial pneumonia before and after treatment,analyze the imaging characteristics of the patients during progression phase,and evaluate its predictive value of prognosis.METHODS A total of 120 cases diagnosed as bacterial pneumonia from Jun.2013 to Dec.2016 in our hospital were enrolled in this study prospectively.The patients were divided into moderate-risk group（65 cases）and highrisk group（55 cases）.The levels of plasma hs-CRP and PCT were detected on admission,the third day and the fifth days during the course of anti-bacterial therapy,and the chest X-ray and CT were checked in radiology department at the same time.RESULTS On admission,the levels of the hs-CRP and PCT of high-risk group were higher than those of moderate-risk group（P〈0.05）.With the prolong interval of treatment,the levels of hs-CRP and PCT in moderate-group were decreased gradually,while in high-risk group,the levels of hs-CRP and PCT were increased（P〈0.05）.The lung inflammatory infiltration degree in high-risk group was positively correlated with the high expression of hs-CRP and PCT（P〈0.05）.The AUC of hs-CRP and PCT to predict death of the high-risk patients were 0.826 and 0.884（P〈0.05）.CONCLUSIONThe bacterial pneumonia patients with different death risk can manifest different imaging characteristics.Detection of hs-CRP and PCT can be benefit to evaluating the patients dynamic clinical condition,and to performing early prediction for prognosis.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第15期3431-3434,共4页
Chinese Journal of Nosocomiology
基金
浙江省医学会临床科研资金项目(2011zyc-B04)
关键词
细菌性肺炎
影像学
降钙素原
超敏C-反应蛋白
预后
Bacterial pneumonia
Imageology
Procalcitonin
Hyper-sensitive C reactive protein
Prognosis
