摘要
目的探究血清降钙素原与C-反应蛋白对单纯急性左心衰竭患者肺部感染的诊断效果,为临床对此类患者的诊断及治疗提供参考。方法选取2016年2月-2018年5月河北北方学院附属第一医院收治的急性左心衰竭患者200例为研究对象,根据肺部感染情况分为对照组97例与研究组103例,对照组为单纯急性左心衰竭患者,研究组为急性左心衰竭并发肺部感染患者。比较两组患者入院第1天、第3天、第5天及第7天的血清降钙素原与C-反应蛋白水平,并分别分析两组血清降钙素原、C-反应蛋白与脑钠肽的相关性,通过ROC曲线图寻求最佳诊断界值。结果入院后第1天、3天、5天及7天,研究组患者的血清降钙素原、C-反应蛋白及脑钠肽水平均高于对照组患者(P<0.001);两组患者的血清降钙素原、C-反应蛋白及脑钠肽水平变化趋势均一致,但并不存在相关性;血清降钙素原最佳诊断界值为0.574μg/L,且当血清降钙素原水平>0.574μg/L时,诊断单纯急性左心衰竭患者肺部感染的特异性及敏感度较好;C-反应蛋白最佳诊断界值为110 mg/L,且当C-反应蛋白水平高于此值时,诊断单纯急性左心衰竭患者肺部感染的敏感性为0.705,特异性为0.762。结论血清降钙素原在诊断单纯急性左心衰竭肺部感染患者时存在最佳诊断界值,且特异性及敏感度均较高,而C-反应蛋白则不适于作为诊断单纯左心衰竭肺部感染患者的标志物。
OBJECTIVE To explore the diagnostic effect of serum procalcitonin and C-reactive protein on pulmonary infection in patients with acute left heart failure,so as to provide reference for clinical diagnosis and treatment of such patients.METHODS 200 patients with acute left heart failure admitted to the First Affiliated Hospital of Hebei North University from Feb.2016 to May 2018 were selected.All patients were divided into control group and observation group according to whether they were complicated by pulmonary infection.The control group consisted of 97 patients with acute left heart failure,and the observation group consisted of 103 patients with acute left heart failure complicated with pulmonary infection.The serum procalcitonin and C-reactive protein levels of the two groups on day 1,day 3,day 5,and day 7 were observed and compared,and the correlation between serum procalcitonin,C-reactive protein and brain natriuretic peptide was analyzed.The best diagnostic threshold was explored from the ROC curve.RESULTS On the first,third,fifth and seventh day after admission,the serum levels of procalcitonin,C-reactive protein and brain natriuretic peptide were significantly higher in the observation group than in the control group(P<0.05).The changes in serum procalcitonin,C-reactive protein and brain natriuretic peptide levels showed consistent trends,but the correlation was not significant.The optimal diagnostic cutoff value of serum procalcitonin was 0.574μg/L,and when serum procalcitonin level was>0.574μg/L,the specificity and sensitivity of diagnosing pulmonary infection in patients with acute left heart failure were higher.The optimal diagnostic cutoff value of C-reactive protein was 110 mg/L,and when the level of C-reactive protein was higher than this value,the sensitivity and specificity of diagnosis of pulmonary infection in patients with acute left heart failure were 0.705 and 0.762,respectively.CONCLUSION Serum procalcitonin has the best diagnostic threshold in the diagnosis of patients with acute left heart failure and pulmonary infection,and the specificity and sensitivity are high,but C-reactive protein is not suitable as a marker for the diagnosis of patients with lung infection in patients with left heart failure.
作者
李宝亮
苏华
李梦嘉
耿丽娜
马俊帅
LI Bao-liang;SU Hua;LI Meng-jia;GENG Li-na;MA Jun-shuai(First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第19期2935-2938,2952,共5页
Chinese Journal of Nosocomiology
基金
河北省科技攻关计划基金资助项目(hz299792)
关键词
血清降钙素原
C-反应蛋白
急性左心衰竭
肺部感染
Serum procalcitonin
C-reactive protein
Acute left heart failure
Pulmonary infection
