降钙素原联合C反应蛋白在老年患者肺部细菌感染中的价值

摘要

目的：探讨降钙素原（PCT）联合C反应蛋白（CRP）在老年患者肺部感染中的诊断价值。方法选取2013年3月至2014年3月泸州医学院附属医院收治的老年住院患者145例，按有无肺部感染及感染严重程度分为无感染组（43例）、局部感染组（68例）、重症感染组（34例），检测其血清PCT、全血CRP水平及白细胞（WBC）计数，并绘制受试者工作特征曲线（ROC曲线），比较各炎症指标对老年患者肺部细菌感染的诊断价值。结果重症感染组PC T水平明显高于局部感染组和无感染组，差异均有统计学意义（P＜0．05），PCT的ROC曲线下面积（AUC）为0．960 ± 0．033，CRP为 0．717 ± 0．084，WBC为0．582 ± 0．094。在PCT阈值为0．2μg／mL时，其诊断灵敏度为95．1％，特异度为88．4％，Youden指数为0．835；在CRP阈值为67．72 mg／L时，其灵敏度为57．8％，特异度为83．7％，Youden指数为0．415。WBC的AUC不具有诊断意义。结论 PCT是一个较为理想的诊断老年患者肺部细菌感染及判断感染严重程度的标志物，PCT联合CRP能更好地辅助诊断老年患者肺部感染。%Objective To investigate the diagnostic value of procalcitonin(PCT) combined with C‐reactive protein (CRP) in the pulmonary infection in elderly patients .Methods 145 cases of inpatients in Affiliated Hospital of Luzhou Medical College from Mar .2013 to Mar .2014 were selected and divided into three groups [non‐infection group (43 cases) ,local infection group (68 ca‐ses) ,severe infection group (34 cases)] according to whether they have pulmonary bacterial infection and the severity of infection . Serum PCT level ,blood CRP level and white blood cell (WBC) counts were detected ,and the receiver operating characteristic curve (ROC curve) were evaluated .The diagnostic values of these inflammatory markers were compared .Results The serum PCT level in the serve infection group was significantly higher than those in the local infection group and non‐infection group (P<0 .05) ,area under the ROC curve (AUC) of PCT was 0 .960 ± 0 .033 ,CRP was 0 .717 ± 0 .084 ,WBC was 0 .582 ± 0 .094 ,respectively .When the threshold of PCT was 0 .2 μg/mL ,the diagnostic sensitivity was 95 .1% ,specificity was 88 .4% ,Youden index was 0 .835 ;when the threshold of CRP was 67 .72 mg/L ,the diagnostic sensitivity was 57 .8% ,specificity was 83 .7% ,Youden index was 0 .415 .The AUC of WBC had no diagnostic value .Conclusion PCT could be an ideal marker in diagnosis of bacterial pneumonia and assessing the severity of infection in elderly patients .PCT combined with CRP ,WBC could provide better auxiliary diagnosis of the pulmonary infection in elderly patients .