摘要
目的 探讨联合检测白细胞计数(WBC)、红细胞沉降率(ESR)、降钙素原(PCT)及C-反应蛋白(CRP)在社区获得性肺炎(CAP)和肺结核(PTB)鉴别诊断中的应用价值。方法 回顾性分析我院2017年12月至2020年8月收治的81例CAP患者和86例PTB患者的临床资料,对WBC、ESR、PCT及CRP在CAP和PTB鉴别诊断中的效能进行统计分析,评估联合检测上述炎症指标在CAP和PTB鉴别诊断中的应用价值。结果 CAP组患者的WBC、PCT及CRP水平均显著高于PTB组,差异有统计学意义(P<0.05),两组患者的ESR水平差异无统计意义(P>0.05)。ROC曲线分析显示,WBC、PCT、CRP均能较好的区别CAP和PTB,其曲线下面积分别为0.755、0.732、0.748;当同时满足WBC>8.60×10^(9)/L、PCT>0.10 ng/mL以及CRP>49.75 mg/L时,其区别CAP及PTB的特异性达93.02%,CAP的阳性预测值达85.00%。结论 CAP患者的WBC、PCT、CRP水平较PTB患者高,三者同时升高应高度考虑为CAP。
Objective To investigate the application value of combined detection of white blood cell count(WBC),erythrocyte sedimentation rate(ESR),procalcitonin(PCT)and C-reactive protein(CRP)in the differential diagnosis of community-acquired pneumonia(CAP)and pulmonary tuberculosis(PTB).Methods The clinical data of 81 CAP patients and 86 PTB patients admitted to and treated in our hospital from December 2017 to August 2020 were retrospectively analyzed.The efficacy of WBC,ESR,PCT and CRP in the differential diagnosis of CAP and PTB was statistically analyzed.And the application value of combined detection of the above inflammatory indices in the differential diagnosis of CAP and PTB was evaluated.Results The levels of WBC,PCT and CRP in patients of the CAP group were all significantly higher than those in the PTB group,with statistically significant differences(P<0.05).However,there was no significant difference in ESR level between the two groups of patients.The Receiver Operating Characteristic(ROC)curve analysis showed that all of WBC,PCT and CRP could differentiate the CAP and PTB well,and the areas under the curve1 were 0.755,0.732 and 0.748,respectively.When WBC>8.60×10^(9)/L,PCT>0.10 ng/mL and CRP>49.75 mg/L were met at the same time,the specificity of differentiating CAP from PTB was 90.02%,and the positive predictive value of CAP was 85.00%.Conclusion The levels of WBC,PCT and CRP in CAP patients are higher than those in PTB patients.When the three indices increase at the same time,the result should be highly considered as CAP.
作者
袁亚婷
张孝斌
曾惠清
YUAN Yating;ZHANG Xiaobin;ZENG Huiqing(Department of Respiratory and Critical Care Medicine,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361004,China)
出处
《中国现代医生》
2021年第26期146-149,I0001,共5页
China Modern Doctor
关键词
社区获得性肺炎
肺结核
白细胞计数
降钙素原
C反应蛋白
红细胞沉降率
Community acquired pneumonia
Pulmonary tuberculosis
White blood cell count
Procalcitonin
C-reactive protein
Erythrocyte sedimentation rate
