目的：探讨降钙素原（PCT）在诊断社区获得性肺炎（CAP）和指导抗生素应用中的价值。方法：回顾性分析2013年5月至2014年5月收住我院呼吸科的CAP患者296例，同期收住的其他患者221例，比较PCT在CAP和非CAP患者之间、老年和非老年CAP之间的差异，作ROC曲线，运用最大约登指数法确定PCT诊断CAP的最佳临界值及相应的灵敏度（SEN）和特异度（SPE）。结果：CAP患者PCT显著高于非CAP患者（P＜0．05）。 PCT诊断CAP的ROC曲线下面积（AUC）是0．67，最佳临界值是0．055 ng／mL，对应的SEN和SPE分别是0．55和0．77。老年CAP患者PCT水平低于非老年CAP患者。 PCT诊断老年CAP的AUC是0．63，最佳临界值是0．55 ng／mL，对应的SEN和SPE分别是0．53和0．73。 PCT诊断非老年CAP的AUC是0．73，最佳临界值是0．085 ng／mL，对应的SEN和SPE分别是0．53和0．90。 PCT指导抗生素应用与临床结合影像学指导抗生素应用比较疗程更短（P＜0．05），而疾病复发率无差异（P＞0．05）。结论：PCT在诊断CAP和指导抗生素应用中具有较高价值。%Objective To explore the role of procalcitonin (PCT) in diagnosis and antibiotics therapy of community acquired pneumonia (CAP). Methods A total of 296 patients with CAP and 221 patients with other diseases were included. PCT levels between CAP patients and non-CAP patients, aged and non-aged CAP patients were analyzed. SPSS19.0 was used to make ROC, and the maximum Youden index to determine the optimal cutoff value, the corresponding sensitivity (SEN) and specificity (SPE). Results PCT levels in CAP patients were significantly higher than those in non-CAP (P<0.05). The diagnostic value of PCT in CAP was as follows: the area under the curve (AUC) was 0.67, the optimal cutoff value 0.055 ng/mL and the SEN and SPE were 0.55 and 0.77 respectively. For aged CAP patients, the values were 0.63, 0.055 ng/mL, 0.53 and 0.73 respectively and for non-aged CAP patients, the values were 0.73, 0.085 ng/mL, 0.53 and 0.90 respectively. The days of treatment in PCT-guided antibiotics therapy group were greatly less than those in clinical and radiology-guided antibiotics therapy (P<0.05), while there was no difference on relapse (P>0.05). Conclusion PCT has a high value in diagnosis and antibiotics therapy of CAP.
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