胸腔积液降钙素原测定对肺炎旁胸腔积液分期的评价价值  

Value of Procalcitonin Level of Pleural Effusion in Staging Diagnosis of Parapneumonic Effusion

作　　者：李明晖[1] 沈巨信[1] 贺群[1] 钟波[1] 

机构地区：[1]绍兴市人民医院呼吸内科,浙江省绍兴市312000

出　　处：《中国全科医学》2010年第19期2111-2112,2116,共3页Chinese General Practice

摘　　要：目的评价胸腔积液降钙素原(PCT)水平在肺炎旁性胸腔积液分期诊断中的价值。方法 42例肺炎旁性胸腔积液患者分为两组:单纯肺炎旁胸腔积液(UCPE)28例、复杂性肺炎旁胸腔积液(CPE)14例,检测两组患者血及胸腔积液中PCT水平。并将19例漏出液患者作为对照组。结果单纯肺炎旁胸腔积液PCT均值为0.3ng/ml,复杂性肺炎旁胸腔积液PCT均值为2.9ng/ml,两者比较差异有统计学意义(P<0.01)。但两组间血清PCT水平比较差异无统计学意义(P>0.05)。在胸腔积液PCT值大于0.5ng/ml时被认为可胸腔闭式引流或胸腔内尿激酶腔内注入或建议胸腔镜治疗(敏感度为91.5%,特异度为87.9%)。结论胸腔积液中PCT测定有助于肺炎旁胸腔积液的分期及指导治疗。Objective To evaluate the value of procalcitonin （PCT） level of pleural effusion to differentiate the stages in diagnosis of parapneumonic effusion （PPE） . Methods Totally 42 atients with pleural effusions were enrolled and divided into two groups： uncomplicated parapneumonic effusion （UCPE） （ n = 28 ） and complicated parapneumonic effusion （CPE） （ n = 14）. PCT levels of blood and pleural effusion samples were measured in the two groups. And 19 transudate patients were enrolled as control group. Results PCT level in pleural effusion was significantly higher in the CPE group （2. 9 ng/ml） than in the UCPE group （0. 3 ng/ml） （P 〈 0. 01 ）, but there was no significant difference in serum PCT （P 〉 0. 05 ）. As the PCT concentration of pleural fluid was more than 0. 5 ng/ml, it was considered an indicator for a treatment by thoracic closed drainage, or thoracic injection of urokinase, or possible thoracoscopic surgery （sensitivity 91.5% and specificity 87.9% ） . Conclusion Pleural effusion PCT detection is helpful to staging diagnosis of parapneumonie effusion and guiding the management.

关 键 词：肺炎旁胸腔积液 降钙素原 分期 

分 类 号：R563.1[医药卫生—呼吸系统]