C反应蛋白、白细胞计数及降钙素原在重症肺炎诊断中的意义  

Clinical significance of serum C-reactive protein,white blood cell count and procalcitonin in the diagnosis of severe pneumonia

作　　者：蔡薛芳[1] 吕群[1] 

机构地区：[1]杭州师范大学附属医院呼吸内科,浙江杭州310015

出　　处：《中国卫生检验杂志》2015年第21期3671-3673,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨C反应蛋白(CRP)、白细胞(WBC)计数及降钙素原(PCT)在重症肺炎诊断中的价值。方法分析不同时间点重症肺炎患者及非重症肺炎患者血清CRP、PCT和外周血WBC变化。结果入院第5 d及第7 d,重症肺炎组的CRP值高于非重症肺炎组,差异有统计学意义(P<0.05)。两组患者的WBC值在入院第1 d、第3 d、第5 d及第7 d差异均无统计学意义(P>0.05);PCT值在入院第1 d、第3 d、第5 d及第7 d差异均有统计学意义(P<0.05)。重症肺炎患者中,入院第5 d CRP值在死亡组与存活组间差异有统计学意义(t=2.01,P<0.05);WBC值及PCT值在死亡组与存活组间差异均无统计学意义(P>0.05);入院第7 d,CRP值、WBC值及PCT值在死亡组与存活组间差异有统计学意义(t值分别为2.81、2.53、2.66,P<0.05)。结论 CRP与PCT的检测对于重症肺炎的早期诊断及重症肺炎的预后判断均较为敏感,可作为判断重症肺炎变化及预后的监测指标,对临床诊治具有指导意义。Objective To investigate the value of CRP,white blood cell count（ WBC） and procalcitonin（ PCT） in the diagnosis of severe pneumonia. Methods The changes of CRP,PCT and WBC of peripheral blood in serum of patients with severe pneumonia at different time and different places were analyzed. Results The CRP value of severe pneumonia group was higher than that of non- severe group on the 5th and 7th day,and the difference has statistical significance（ P〈 0. 05）. Between severe and non- severe pneumonia groups,the differences of WBC level had no statistical significance on the 1st,3rd,5th and 7th day after admission（ P〈 0. 05）; the differences of PCT level had statistically significance on the 1st,3rd,5th and 7th day after admission（ P〈 0. 05）; on the 5th and 7th day after the admission,the CRP value was significantly higher than that of non- severe pneumonia group and the differences had statistical significance（ P〈 0. 05）. In severe pneumonia patients,on the 5th day after the admission the difference between the CRP values in the death group and the survival group was statistically significant（ t =2. 01,P〈 0. 05）; there was no significant difference between the WBC value and PCT value in the death group and the survival group（ P〈 0. 05）; on the 7th day after admission,the difference among CRP value,WBC value and PCT value in the death group and survival group was statistically significant and the values of the death group were higher of than those of survival group（ t = 2. 81,2. 53,2. 66,P〈 0. 05）. Conclusion The detection of CRP and PCT is sensitive to early diagnosis and prognosis of severe pneumonia,and can be used as a monitoring index for the changes and prognosis of severe pneumonia,which has a guiding significance for clinical diagnosis and treatment.

关 键 词：重症肺炎 C反应蛋白 白细胞计数 降钙素原 

分 类 号：R563.1[医药卫生—呼吸系统]