摘要
目的探讨血清降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)及白介素-6(interleukin-6,IL-6)联合检测对社区获得性肺炎(community-acquired pneumonia,CAP)患者诊断及预后评估中的价值。方法选取2019年2月至2021年2月期间入住北京大学首钢医院急诊科的社区获得性肺炎患者152例为观察组,同期急诊科的健康体检人员30例为对照组。采用肺炎严重程度CURB-65评分将152例观察组分为低危组(n=84例),CURB评分<3分,和高危组(n=68例),CURB评分≥3分。依照观察组住院期间的转归情况分为存活组(n=134例)和死亡组(n=18例)。比较观察组和对照组,低危组和高危组,存活组和死亡组患者的PCT、CRP及IL-6的差异,同时采用受试者工作特征(ROC)曲线分析观察组3种血清标志物对社区获得性肺炎患者预后评估的价值。结果观察组患者的PCT、CRP及IL-6水平明显高于对照组(P<0.05);高危组患者的PCT、CRP及IL-6水平明显高于低危组(P<0.05);死亡组患者的PCT、CRP及IL-6水平明显高于存活组(P<0.05);并经Pearson相关性分析发现,CURB-65评分与PCT、CRP及IL-6呈明显正相关(相关系数r=0.640、0.621、0.529,P均<0.01)。ROC曲线分析显示,PCT、CRP及IL-6预测社区获得性肺炎的灵敏度分别为83.30%、77.80%、72.20%,特异性分别85.80%、81.30%、80.60%,而三者联合检测的灵敏度和特异性均明显升高,分别为88.90%、88.10%。结论PCT、CRP及IL-6联合检测可为社区获得性肺炎的诊断和预后评估提供重要价值,指导临床实践。
Objective To explore the value of combined-biomarker detection of serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)in the diagnosis and prognostic evaluation of patients with community-acquired pneumonia(CAP).Methods 152 patients with community-acquired pneumonia who were admitted to the emergency department of Peking University Shougang Hospital from February,2019 to February,2021 were selected as the observation group,while 30 healthy medical examiners from the Emergency Department during the same period were selected as the control group.Using the CURB-65 score of severity of pneumonia,the observation group was divided into the low-risk group(n=84 cases)with CURB score<3 points,and high-risk group(n=68 cases)with CURB score≥3 points.According to the outcome of the observation group during hospitalization,patients were divided into the survival group(n=134 cases)and death group(n=18 cases).We then compared the differences of PCT,CRP and IL-6 between the observation group and the control group,low-risk group and high-risk group,survival group and death group.At the same time,the receiver operating characteristic(ROC)curve was drawn to analyze the three blood markers’value to the prognostic evaluation for patients with community-acquired pneumonia.Results The levels of PCT,CRP and IL-6 in the observation group were significantly higher than those in the control group(P<0.05).The levels of PCT,CRP and IL-6 in the high-risk group were significantly higher than those in the low-risk group(P<0.05).The levels of PCT,CRP and IL-6 in the death group were significantly higher than those in the survival group(P<0.05).Pearson correlation analysis showed that the CURB-65 score was significantly positively correlated with PCT,CRP and IL-6(correlation coefficient r=0.640,0.621,0.420,P<0.01).ROC curve analysis showed that the sensitivities of PCT,CRP,and IL-6 to predict community-acquired pneumonia were 83.30%,77.80%,and 72.20%,while the specificities were 85.80%,81.30%,and 80.60%,respectively.The sen
作者
张春燕
农金轻
范宝军
马莹暄
祝振忠
宋建梅
ZHANG Chunyan;NONG Jinqing;FAN Baojun;MA Yingxuan;ZHU Zhenzhong;SONG Jianmei(Department of Emergency, Peking University Shougang Hospital, Beijing 100144, China;Department of Clinical Laboratory, Peking University Shougang Hospital, Beijing 100144, China;Department of Clinical Laboratory, West Hospital of Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China)
出处
《标记免疫分析与临床》
CAS
2021年第6期927-931,共5页
Labeled Immunoassays and Clinical Medicine
基金
北京市“石景山区医学重点扶持专科建设”(编号:石卫健医发[2020]21号)。
