摘要
目的探讨血清降钙素原(PCT)水平在呼吸机相关性肺炎(VAP)早期诊断及病情判断中的价值。方法选择暨南大学第二临床医学院2011年1月至2012年7月入住重症监护室并疑诊为VAP的患者60例,按诊断标准分为VAP组(33例)和非VAP组(27例),测定两组患者的PCT、C-反应蛋白(CRP)和白细胞计数(WBC)值,VAP组的33例患者在治疗后第5天再次进行PCT检测并进行临床肺部感染评分(CPIS),根据病情转归又分为好转组(18例)和恶化组(15例)。结果 VAP组的PCT、WBC和CRP值均高于非VAP组,差异有统计学意义;PCT诊断VAP的敏感性与CRP比较差异无统计学意义,但其特异性、阳性预测值和阴性预测值均高于CRP,PCT诊断VAP的敏感性、特异性、阳性预测值和阴性预测值均高于WBC;VAP组经治疗后好转组的PCT和CPIS值均低于恶化组,差异有统计学意义;PCT与CPIS呈正相关。结论血清PCT水平的测定有助于VAP的早期诊断,动态监测PCT水平变化对病情判断有重要指导意义。
Objective To investigate the value of serum procalcitonin（PCT） in the early diagnosis and prognosis estimation of ventilator associated pneumonia（VAP）.Methods Sixty patients who were admitted into the intensive care unit in the second clinical medical college of Jinan university from January 2011 to July 2012 suspected diagnosis of VAP were selected,then the patients were divided into VAP group（33 cases）and non-VAP group（27 cases） according to the diagnostic criterion.PCT levels,CRP and WBC count of both groups were detected,then the PCT levels of the VAP group patients were detected again and the clinical pulmonary infection score（CPIS） of the VAP group patients were calculated 5 days after the treatment.And the VAP group patients were divided into improvement group（18 cases） and deterioration group（15 cases） depending on the curative effect.Results The PCT,CRP and WBC count in VAP group patients were significantly higher than those in non-VAP group.There was no difference in sensitivity of PCT and CRP to diagnose VAP,but the specificity,positive predictive rates and negative predictive rates of PCT to diagnose VAP were higher than those of CRP,the sensitivity,specificity,positive predictive rates and negative predictive rates of PCT in diagnose of VAP were higher than those of WBC.The PCT and CPIS in improvement group were significantly lower than those in deterioration group.There was significantly positive correlation between PCT and CPIS.Conclusion The detection of serum PCT is helpful for the early diagnosis of VAP.Monitoring the dynamic change of PCT level is significant for the estimation of the illness.
出处
《临床医学》
CAS
2013年第3期20-22,共3页
Clinical Medicine
关键词
降钙素原
肺炎
呼吸机相关性
诊断
Procalcitonin
Pneumonia
Ventilator associated
Diagnosis
