PCT、CRP、ESR和WBC对肺结核合并肺部感染诊断的比较

摘要

目的：探讨血清降钙素原( PCT)、C-反应蛋白( CRP)、红细胞沉降率( ESR)和白细胞( WBC)计数对肺结核( PTB)合并肺部感染诊断的差异性。方法检测临床确诊为活动性PTB合并肺部感染和未合并感染患者血PCT、CRP、ESR和WBC,采用SPSS 16．0软件对两组资料进行统计分析, MedCalc V12.7.7.0软件进行接受者操作特性( ROC)曲线分析,计算并比较各指标曲线下面积( AUC),确定最佳临界值。结果合并感染组血PCT、CRP、ESR和WBC均高于未合并感染组,差异有统计学意义(均 P<0．01)；4个指标诊断PTB合并肺部感染的AUC分别是0．89、0．75、0．74和0．72,PCT的AUC明显高于其他三个指标,差异有统计学意义(P<0．01)；最佳临界值分别是0．29 ng/ml、15．00 mg/L、37．00 mm/h和7．86×109/L。结论血PCT、CRP、ESR和WBC对诊断PTB合并肺部感染均有一定价值,PCT优于其他3个指标。%Objective To investigate the differences among serum procalcitonin ( PCT) , C-reactive protein ( CRP) , erythrocyte sedimentation rate ( ESR) and white blood cell count ( WBC) in diagnosing pulmonary tubercu-losis ( PTB) complicated with pulmonary infection. Methods The levels of PCT, CRP, ESR and WBC were detec-ted in active PTB patients complicated with pulmonary infection and patients without infection. The data was analyzed statistically by SPSS16. 0 software. The receiver operating characteristic ( ROC) curves and area under the curve (AUC) of each indicator were analyzed by MedCalc V12. 7. 7. 0 software. AUC and the cut-off values were calculated and compared by ROC. Results Blood PCT, CRP, ESR and WBC level in PTB patients complicated with pulmona-ry infection were all significantly higher those without infection ( P<0. 01 ) . The AUC of four indicators diagnosing PTB complicated with pulmonary infection were 0. 89, 0. 75, 0. 74 and 0. 72 respectively, and AUC of PCT was sig-nificantly higher than the other three indicators (P<0. 01). The cut-off values of PCT, CRP, ESR and WBC were 0. 29 ng/ml, 15. 00 mg/L, 37. 00 mm/h and 7. 86 × 109/L respectively. Conclusion Blood PCT, CRP, ESR and WBC level may be useful in the diagnosis of PTB complicated with pulmonary infection and PCT is better than the other three indicators.