降钙素原在老年细菌性肺炎诊断中的临床应用价值_West China Medical Journal

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降钙素原; 细菌性肺炎; 早期诊断

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10.7507/1002-0179.20130544

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目的　探讨降钙素原（PCT）在老年细菌性肺炎诊断中的临床应用价值。方法　将2007年1月－2012年1月就诊的581例疑似细菌性肺炎老年患者，按出院（或死亡）诊断分为细菌性肺炎组和非细菌性肺炎组，对两组患者在应用抗生素前测定PCT、C反应蛋白（CRP）、外周血白细胞计数（WBC）、中性粒细胞百分比（N%）血沉及痰培养，并比较这些检验指标对细菌性肺炎诊断的灵敏度、特异度、阳性似然比、阴性似然比。结果　血清PCT在细菌性肺炎组阳性率高于非细菌性肺炎组。PCT检测对细菌性肺炎诊断的灵敏度为54.45%，特异度为88.46%，阳性似然比为12.69%，阴性似然比为0.17%。CRP灵敏度为95.45%，特异度为8.33%；阳性似然比为4.58%，阴性似然比为3.17%。在各项指标中，PCT的特异度最高，CRP的灵敏度最高，阳性似然比最高为痰培养，阴性似然比最低为PCT。结论　血清PCT可作为老年细菌性肺炎的检测指标，其作用优于CRP、WBC、N%、血沉、痰培养等指标；通过与CRP结合，可早期诊断、及时治疗细菌性肺炎。

Citation： 高宇,黄志亮,王春梅,侯殿臣. 降钙素原在老年细菌性肺炎诊断中的临床应用价值. West China Medical Journal, 2013, 28(11): 1731-1733. doi: 10.7507/1002-0179.20130544 Copy

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1. 　Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection[J]. Lancet, 1993, 341(5): 515-518.
2. 　孙振球. 医学统计学[M]. 2版. 北京: 人民卫生出版社, 2005: 399-448.
3. 　Kim JH, Seo JW, Mok JH, et al. Usefulness of plasma procalcitonin to predict severity in elderly patients with community-acquired pneumonia[J]. Tuberculosis and respiratory diseases, 2013, 74(5): 207-214.
4. 　Lacoma A, Prat C, Andreo F, et al. Value of procalcitonin, C-reactive protein, and neopterin in exacerbations of chronic obstructive pulmonary disease[J]. Int J Chron Obstruct Pulmon Dis, 2011, 6: 157-169.
5. 　Hillas G, Vassilakopoulos T, Plantza P, et al. C-reactive protein and procalcitonin as predictors of survival and septic shock in ventilator-associated pneumonia[J]. Eur Respir J, 2010, 35(4): 805-811.
6. 　刘少锋, 杨健, 刘敏. 降钙素原与创伤的研究进展[J]. 华西医学, 2012, 27(5): 789-793.
7. 　Seligman R, Seligman BG, Teixeira PJ. Comparing the accuracy of predictors of mortality in ventilator-associated pneumonia[J]. J Bras Pneumol, 2011, 37(4): 495-503.
8. 　Schuetz P, Suter-Widmer I, Chaudri A, et al. Prognostic value of procalcitonin in community-acquired pneumonia[J]. Eur Respir J, 2011, 37(2): 384-392.
9. 　Boeck L, Eggimann P, Smyrnios N, et al. Midregional pro-atrial natriuretic peptide and procalcitonin improve survival prediction in VAP[J]. Eur Respir J, 2011, 37(3): 595-603.
10. 　吴祖凤, 汪铮, 李秀, 等. 社区获得性肺炎住院患者血清降钙素原与肺炎严重程度和预后的关系[J]. 安徽医药, 2011, 15(10): 1278-1280.
11. 　Christ-Crain M, Opal SM. Clinical review: the role of biomarkers in the diagnosis and management of community-acquired pneumonia[J]. Crit Care, 2010, 14(1): 203.
12. 　Stolz D, Smyrnios N, Eggimann P, et al. Procalcitonin for reduced antibiotic exposure in ventilator-associated pneumonia: a randomised study[J]. Eur Respir J, 2009, 34(6): 1364-1375.

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降钙素原在老年细菌性肺炎诊断中的临床应用价值

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