摘要
目的分析血清降钙素原(PCT)对老年社区获得性细菌性肺炎的诊断价值及对抗生素药物使用的指导作用。方法将我院确诊为社区获得性肺炎的老年患者100例根据致病菌的不同分为细菌组60例、病毒组20例和支原体组20例,比较三组血清降钙素原、C-反应蛋白和白细胞计数的水平差异。细菌组的60例中30例患者(PCT组)根据血清降钙素原的水平变化来指导抗生素的应用,另外30例患者(常规组)采用常规方法使用抗生素,比较两小组临床治疗效果和炎性指标的变化。结果细菌组患者的血清降钙素原水平[(1.73±0.43)μg/L]明显高于病毒组[(0.12±0.03)μg/L]和支原体组[(0.19±0.05)μg/L](P<0.05);血清降钙素原对老年社区获得性细菌性肺炎的诊断特异性(96.67%)明显优于C-反应蛋白(66.67%)(P<0.05)。细菌组治疗后,PCT组各项指标明显好于常规组,差异有统计学意义(P<0.05)。结论血清降钙素原诊断老年社区获得性细菌性肺炎的特异性较高,对抗生素药物的应用具有指导应用,避免了细菌耐药的发生,建议在临床上广泛使用。
Objective To analyze the diagnostic value of serum procalcitonin（ PCT） in elderly patients with community-acquired bacterial pneumonia and its role in guiding the use of antibiotics. Methods 100 elderly patients diagnosed as community-acquired pneumonia in our hospital were divided into three groups according to the pathogens： 60 cases in the Bacteria group,20 in the Virus group,and 20 in the Mycoplasma group; The serum PCTs,C-reactive proteins and white blood cell counts（ WBCs） of the three groups were compared. The patients in Bacteria group were further divided into the PCT group（ n = 30）,who accepted antibiotic treatment based on their PCT level changes,and the Routine group（ n = 30）,who were given conventional antibiotic therapy; The clinical outcomes and inflammation marker changes in the two subgroups were compared. Results The serum PCT levels of the patients in Bacteria group [（ 1. 73 ± 0. 43） μg / L]were significantly higher than those in Virus group [（ 0. 12± 0. 03） μg / L] and Mycoplasma group [（ 0. 19 ± 0. 05） μg / L]（ P〈0. 05）. The diagnostic specificity of serum PCT for elderly community-acquired bacterial pneumonia（ 96. 67%） was significantly better than that of C-reactive protein（ 66. 67%）（ P〈0. 05）. The clinical outcomes of patients in PCT subgroup was significantly better than those in Routine group（ P〈0. 05）. Conclusion Serum procalcitonin has high diagnostic specificity for elderly community-acquired bacterial pneumonia,which can play a guiding role for antibiotic drug application and help to avoid the occurrence of bacterial resistance.
出处
《中国微生态学杂志》
CAS
CSCD
2015年第7期840-843,共4页
Chinese Journal of Microecology
关键词
降钙素原
社区获得性肺炎
C-反应蛋白
白细胞计数
诊断
Procalcitonin
Community-acquired pneumonia
C-reactive protein
White blood cell count
Diagnosis
