血清降钙素原在老年患者肺部感染诊治中的临床应用

摘要

Objective To evaluate the clinical application of procalcitonin(PCT) in the diagnosis and treatment of pulmonary infection in elderly patients.Methods 120 elderly patients with pulmonary infection as pneumonia group, according to the prognosis were divided into survival group and death group.Another 40 patients with non-infectious bronchial disease into control group.The PCT、CRP levels and APACHEⅡ scores were recorded and compared before treatment,3 days and 10 days after treatment.Results Before treatment PCT and CRP levels were higher in Pneumonia groups than the control group (P<0.01),but there was no statistically significant difference in white blood cell count (P>0.05).PCT levels and APACHEⅡscore has no statistical significance difference between survival group and death group before treatment (P>0.05).After treatment,APACHEⅡ scores of survival group rise as death group reduce;PCT levels of survival group reduce as death group rise.PCT levels and APACHE Ⅱ score has statistical significance difference between survival group and death group after 3 days and 10 days treatment ( P<0.05 ) .Conclusions PCT has significance to the elderly patients with pulmonary infection in early diagnosis, judgement of severity and prognosis, worthy of clinical popularization and application.%目的：探讨血清降钙素原在老年患者肺部感染诊治中的价值。方法120例老年肺炎患者为肺炎组，按预后情况分为生存组和死亡组，非感染性支气管疾病患者40例为对照组。在治疗前、治疗3天后、治疗10天后检测血清降钙素原和CRP，评价APACHEⅡ水平并进行比较分析。结果肺炎组治疗前血清降钙素原及CRP水平均较对照组升高（ P＜0．01），白细胞计数差异无统计学意义（ P＞0．05）；入院第1天生存组与死亡组肺部感染患者在PCT水平和APACHEⅡ评分差异无统计学意义（ P＞0．05）。治疗后生存组随着APACHEⅡ评分增高，血清PCT水平逐渐降低；死亡组APACHEⅡ评分逐渐下降，血清PCT水平增高；入院治疗3天后及治疗10天后两组肺部感染患者PCT水平和APACHEⅡ评分差异有统计学意义（ P＜0．05）。结论血清降钙素原对老年患者肺部感染早期诊断、严重程度及预后判断有意义，值得临床推广应用。