摘要
目的探讨降钙素原在有基础疾病的老年慢性阻塞性肺疾病急性加重(AECOPD)合并肺炎患者的表达水平及其诊断价值。方法入选72例有基础疾病的老年AECOPD患者,42例老年社区获得性肺炎(CAP)患者,以40例健康老年人为对照组。对患者的血清降钙素原以及C反应蛋白、白细胞、痰培养进行分析比较。使用ROC曲线下面积评价PCT对于AECOPD并肺炎的诊断价值。结果有基础疾病的老年AECOPD并肺炎组PCT水平与老年CAP组比较,差异无统计学意义(P=0.640),表明患者的营养状态和基础疾病未影响感染刺激PCT的分泌。两组患者PCT测量值明显高于健康对照组(P<0.05)。在诊断率上,CAP组的PCT阳性率高于AECOPD组,差异有统计学意义(χ2=6.258,P=0.012)。在诊断价值方面,PCT的ROC曲线下面积分别为0.914,CRP的ROC曲线下面积为0.665,PCT较CRP对老年AECOPD并肺炎患者诊断价值更大。结论 PCT对老年AECOPD并肺炎患者具有很高的诊断准确性,营养状态和基础疾病不影响PCT的诊断。
Objective To explore the expression level and its clinical significance of serum procalcitonin（PCT） in elderlyacute exacerbation of chronic obstructive pulmonary disease（AECOPD） patients with pneumonia and underlying diseases.Methods A total of 72 elderly AECOPD cases with underlying diseases and 42 elderly patients with community-acquiredpneumonia（CAP）were investigated and 40 healthy elderly people were selected as control group. The levels of serum PCT, c-reactive protein, white blood cells and results of sputum culture of the patients were detected for analysis and comparison.Areas under ROC curve were used to assess the value of PCT expression in diagnosis of AECOPD combined with pneumonia.Results The serum PCT levels in AECOPD patients with pneumonia showed no statistically significant difference comparedto that in CAP patients（P=0.640）,indicating that the patients’ nutritional status and underlying diseases did not affect thesecretion of PCT. Serum PCT levels in cases of the above 2 groups were significantly higher than that in control group（P〈0.05）. The positive rate of PCT in cases of CAP group was higher than that in AECOPD group, the difference was statisticallysignificant（χ2=6.258, P=0.012）.Areas under ROC curve of PCT and CRP were 0.914 and 0.665 respectively,the expression ofserum PCT was more valuable in diagnosis of elderly AECOPD combined with pneumonia compared to that of CRP.Conclusion Detection of the expression of PCT allows accurate diagnosis of elderly AECOPD patients with pneumonia,andthe nutritional status and underlying diseases are not associated with the expression of PCT.
出处
《中国热带医学》
CAS
2015年第4期469-472,共4页
China Tropical Medicine
