降钙素原对危重症患者呼吸机相关性肺炎早期诊断与预后判断的价值

摘要

Objective To study the value of procalcitonin ( PCT) for early diagnosis and prognostic judgment in critically patients with ventilator associated pneumonia .Methods Eighty-two critically patients with suspected ventilator associated pneumonia were detected for their WBC count,C-reactive protein(CRP) and PCT levels.Eighty-two patients were divided into diagnosis group (42 cases) and non-diagnosis group(40 cases) according the confirmed diagnostic results.The patients in the diagnosis group were detected for PCT after 5-day routine treatment ,and their clinical pulmonary infection scores(CPIS) were assessed.The patients in the diagnosis group were divided into recovery group (22 cases) and deterioration group (20 cases ) according to their CPIS scores .The related indexes including PCT , CRP levels and WBC count were compared between diagnosis group and non-diagnosis group as well as recovery group and deterioration group . Results The serum PCT ,CRP levels and WBC count in the diagnosis group were significantly higher than those in the non-diagnosis group(P<0.05).The serum PCT,CRP levels,WBC count and CPIS scores in the recovery group were significantly lower than those in the deterioration group (P<0.05).Conclusion PCT is valuable in the early diagnosis of critically patients with VAP ,and dynamically monitoring PCT plays an active role on judging the prognosis of VAP.%目的：探讨降钙素原（ PCT ）对危重症患者呼吸机相关性肺炎（ VAP ）早期诊断与预后判断的价值。方法疑似危重症VAP患者82例，检测其白细胞计数、C-反应蛋白及PCT水平。根据确诊结果将82例患者分为确诊组42例与非确诊组40例，其中确诊组患者常规治疗5 d后再检测PCT，并进行临床肺部感染评分（CPIS），根据CPIS分为良好组22例与恶化组20例。对比确诊组与非确诊组、良好组与恶化组间PCT、C-反应蛋白水平及白细胞计数等相关指标。结果确诊组患者血清PCT、C-反应蛋白及白细胞计数水平均明显高于非确诊组（P＜0．05）。良好组患者血清PCT、C-反应蛋白水平、白细胞计数与CPIS分值均明显低于恶化组（P＜0．05）。结论 PCT对危重症VAP早期诊断有重要价值，动态监测PCT对于VAP预后判断有积极的意义。