降钙素原、超敏C反应蛋白检测在肺部感染疾病鉴别诊断中的应用价值

中国当代医药2019年3月第26卷第9期CHINA MODERN MEDICINE Vol.26No.9March 2019·检验医学·肺部感染为气管-支气管和肺实质的感染,是临

床下呼吸道感染中常见的疾病之一,一般由细菌、病毒、真菌及某些非典型病原体感染引起的肺实质炎性病变,病因以感染最多见,还可以由理化因素、免疫因

降钙素原、超敏C-反应蛋白检测在肺部感染疾病

鉴别诊断中的应用价值

刘小花任铭铭陈涛陈宇宁

成都市新都区人民医院医学检验科,四川成都

610500[摘要]目的探讨降钙素原(PCT)和超敏C-反应蛋白(hs-CRP)在肺部感染疾病鉴别诊断中的临床价值,指导临床合理应用抗生素。方法选取2015年7月~2017年6月在我院收治的肺部感染患者112例(革兰阴性菌组59例,革兰阳性菌组21例,真菌组32例)为观察组,选取同期健康者48例为对照组,检测各组的血清PCT 和hs-CRP 水平。结果革兰阴性菌组的PCT 水平明显高于革兰阳性菌组、真菌组和对照组,差异均有统计学意义(P <0.05);革兰阳性菌组的PCT 水平明显高于真菌组和对照组,差异有统计学意义(P <0.05);真菌组的PCT 水平明显高于对照组,差异有统计学意义(P <0.05)。革兰阴性菌组、革兰阳性菌组、真菌组的血清hs-CRP 水平明显高于对照组,差异有统计学意义(P <0.05);三组的hs-CRP 水平比较,差异无统计学意义(P >0.05)。结论PCT 水平可以区别革兰阴性菌、革兰阳性菌及真菌感染,PCT 检测值在一定程度可以鉴别肺部感染病原体,具有一定的临床用药指导作用;hs-CRP 检测值可用来反应肺部感染患者的炎症程度,PCT 及hs-CRP 联合检测可作为肺部感染疾病早期鉴别诊断的指标,有较好的临床应用价值。

[关键词]降钙素原;超敏C-反应蛋白;肺部感染[中图分类号]R563.1+9[文献标识码]A [文章编号]1674-4721(2019)3(c)-0149-03

Application value of procalcitonin and high sensitivity C-reactive protein in differential diagnosis of pulmonary infection disease LIU Xiao-hua REN Ming-ming CHEN Tao CHEN Yu-ning

Department of Medical Laboratory,Xindu District People′s Hospital of Chengdu City,Sichuan Province,Chengdu

610500,China [Abstract]Objective To explore the clinical value of procalcitonin (PCT)and high sensitivity C-reactive protein (hs-CRP)in the differential diagnosis of pulmonary infection,and to guide clinical rational use of antibiotics.Methods All of 112cases of pulmonary infection (59cases of Gram-negative bacteria,21cases of Gram-positive bacteria and 32cases of fungi)in our hospital from July 2015to June 2017were selected as observation group.48healthy persons in the same period were selected as control group.Serum PCT and hs-CRP levels in each group were detected.Results The PCT level of Gram-negative bacteria group was significantly higher than that of Gram-positive bacteria group,fun?gal group and control group,and the differences were statistically significant (P <0.05).The PCT level of Gram-positive bacteria group was significantly higher than those of fungal group and control group,and the differences were statisti?cally significant (P <0.05).The PCT level of fungal group was significantly higher than that of control group,and the difference was statistically significant (P <0.05).The serum hs-CRP level of Gram-negative bacteria group,Gram-posi?tive bacteria group and fungal group were significantly higher than that of control group,and the differences were sta?tistically significant (P <0.05),there was no statistical difference in the CRP level among the three groups (P >0.05).Conclusion PCT level can distinguish Gram-negative bacteria,Gram-positive bacteria and fungal infections.PCT de?tection value can identify lung infection pathogens to a certain extent,and has certain clinical drug guiding effects.The hs-CRP test value can be used to reflect the degree of inflammation with pulmonary infection in patients.PCT and hs-CRP combined test can be used as an early differential diagnosis of pulmonary infection diseases,and have a good

clinical application value.[Key words]Procalcitonin;High sensitivity C-reactive protein;Pulmonary infection [作者简介]刘小花(1986-),女,硕士,主管技师,主要从事临床医学检验工作149