论文部分内容阅读
目的探讨血清降钙素原(procalcitonin,PCT)及C反应蛋白(C-reactive protein,CRP)、WBC在老年细菌性肺炎诊断中的价值。方法选择2015年1—7月收治的老年社区获得性肺炎患者162例(其中细菌性感染组96例、非细菌感染66例),体检中心健康体检者80例作为对照组,采用免疫透射比浊法测定CRP水平,采用酶联免疫荧光法测定PCT水平,采用迈瑞公司生产的BC-5500检测血常规,测定PCT、CRP及WBC。计量资料多组间比较采用方差分析,进一步两两比较采用LSD-t检验;灵敏度、特异度比较用χ~2检验;采用受试者工作特征(receiver operating characteristic,ROC)曲线分析PCT、WBC、CRP的诊断价值。P<0.05为差异有统计学意义。结果 PCT、CRP及WBC对老年性社区获得性细菌性肺炎的诊断灵敏度分别为92.71%、87.50%、75.00%,特异度分别为92.4%、40.9%、46.9%,PCT灵敏度、特异度最高(均P<0.05).PCT、WBC、CRP诊断老年社区获得性细菌性肺炎患者的最佳截点分别为0.27ng/ml、12.5×10~9/L、16.5mg/L,其曲线下面积分别为0.995、0.691、0.836,PCT的诊断效能最高(均P<0.05)。结论与CRP、WBC比较,PCT诊断老年社区获得性肺炎价值最高。
Objective To investigate the value of serum procalcitonin (PCT) and C-reactive protein (CRP) and WBC in the diagnosis of elderly bacterial pneumonia. Methods A total of 162 elderly patients with community-acquired pneumonia (96 in bacterial infection group and 66 in non-bacterial group) were enrolled from January to July in 2015. Eighty healthy subjects in physical examination center were selected as control group. Immunoturbidimetry CRP levels were measured by ELISA, PCT levels were measured by enzyme-linked immunosorbent assay, and blood samples were collected by Mindray BC-5500 for determination of PCT, CRP and WBC. The variance analysis was used to compare the measurement data among multiple groups, LSD-t test was further used to compare the sensitivity and specificity, and the χ ~ 2 test was used to compare the sensitivity and specificity. The receiver operating characteristic (ROC) curve was used to analyze the PCT, WBC, CRP diagnostic value. P <0.05 for the difference was statistically significant. Results The diagnostic sensitivities of PCT, CRP and WBC to senile community-acquired bacterial pneumonia were 92.71%, 87.50% and 75.00%, respectively, and their specificity were 92.4%, 40.9% and 46.9%, respectively. The sensitivity and specificity of PCT were the highest P <0.05) .The best cut-off points of diagnosis of community-acquired bacterial pneumonia in elderly patients with PCT, WBC and CRP were 0.27ng / ml, 12.5 × 10-9 / L, 16.5mg / L, 0.995,0.691,0.836, the highest diagnostic efficacy of PCT (all P <0.05). Conclusion Comparing with CRP and WBC, PCT has the highest value in diagnosing community-acquired pneumonia in the elderly.