降钙素原在卒中相关性肺炎诊断和预后中的作用

摘要

Objective To observe the value of procalcitonin (PCT ) in the diagnosis ,treatment and prognosis judgement of stoke-associated pneumonia(SAP) .Methods The serum procalcitonin ,hs-CRP and clinical pulmonary infection scores (CPSI) of two groups were detected :SAP group(including 27 patients of stoke-associated pneumonia) and control group(including 31 healthy ob-jects) .Results The CPSI ,hs-CRP and serum concentration of PCT in SAP group were significantly higher than control group (P<0 .01) ,and decreased significantly when get better after treatment .The serum concentration of PCT in SAP group was significantly higher than control group(P<0 .01) .In SAP group ,the serum concentration of PTC was positively associated with CPSI scorers . Moreover ,the results of ROC analysis showed that the cut-off of serum procalcitonin for the diagnosis of SAP was 0 .9 ng/mL .The sensitivety was 88 .6% and the specifity was 79 .3% ,which was superior to hs-CRP .Conclusion The serum concentration of PCT in SAP patients is higher and it is associated with the prognosis .It might be a better clinical marker for the diagnosis and prognosis of SAP .%目的：探讨降钙素原（PCT）在卒中相关性肺炎（SAP）的诊断、治疗及预后判断过程中的作用。方法检测27例SAP患者、31例卒中对照者的血清中PCT、高敏C反应蛋白（hs-CRP）浓度，计算临床肺部感染评分（CPIS），并进行统计学分析。结果SAP组患者的CPSI、hs-CRP、血清PCT浓度明显高于卒中组（P＜0．01），在治疗好转后均明显下降。在SAP患者中，死亡组患者的PCT浓度明显高于存活组（P＜0．01）。相关分析显示，血清PCT浓度与CPSI呈正相关。ROC曲线分析结果显示，血清PCT诊断SAP的临界值为0．9ng/mL，其灵敏度及特异度分别为88．6％和79．3％，明显优于hs-CRP的诊断价值。结论SAP患者的血清PCT明显升高，且与患者的预后相关，对SAP诊断的价值明显高于hs-CRP。PCT可以作为SAP患者诊断、病情和预后评估的较好临床指标之一。