肺部感染评分、降钙素原及C反应蛋白对特发性肺纤维化并发感染的诊断意义  

Diagnostic value of pulmonary infection score,calcitonin and C reactive protein in patients with idiopathic pulmonary fibrosis complicated with infection

作　　者：王钧[1] 任瑞华[1] 高勇[1] 侯宏伟[1] 王亮[1] 孙金昊[1] 

机构地区：[1]河北省胸科医院急诊科,河北石家庄050041

出　　处：《河北医科大学学报》2016年第7期780-783,共4页Journal of Hebei Medical University

摘　　要：目的探讨简化临床肺部感染评分(clinical pulmonary infection score,CPIS)、降钙素原(procalcitonin,PCT)及C反应蛋白(C-reactive protein,CRP)对特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)并发肺部细菌感染的诊断意义、相关性以及联合使用的临床诊断价值。方法选择疑似IPF伴肺部细菌感染患者98例,检测PCT、CRP,计算简化CPIS,统计PCT、CRP、简化CPIS诊断IPF并发肺部细菌感染的敏感度、特异度、准确度。分析PCT与CPIS的相关性。结果简化CPIS、PCT诊断IPF伴肺部感染的敏感度、特异度、准确度高于CRP,PCT联合简化CPIS诊断IPF伴肺部感染特异度、准确度高于单独简化CPIS和PCT,而敏感度未提高。常规炎症指标中,PCT与CPIS呈显著正相关(r=0.450,P=0.000)。结论简化CPIS联合PCT检测有助于提高IPF并发肺部细菌感染早期诊断特异度,且敏感度未提高。Objective To explore the diagnostic significance,correlation and clinical diagnosis value of the simplified clinical pulmonary infection score（ CPIS）,procalcitonin（ PCT） and C-reactive protein（ CRP） in idiopathic pulmonary fibrosis（ IPF） complicated with pulmonary bacterial infection.Methods A total of 98 adult patients,who were clinically diagnosed as IPF complicated with pulmonary bacterial infection,were enrolled in this prospective diagnostic test,monitoring various inflammatory indicators such as CRP,PCT,calculating the simplified CPIS on the first day of the admission. The sensitivity,specificity, accuracy of PCT, CRP and CPIS for the diagnosis of IPF combined with pulmonary bacterial infections were calculated after the experiment. Results The sensitivity,specificity and accuracy of PCT and CPIS in the diagnosis of IPF with pulmonary infection was higher than that of CRP. The specificity and accuracy of PCT combined with simplified CPIS in diagnosis of IPF with pulmonary infection was higher than that of CPIS and PCT,but the sensitivity was not improved. The PCT and CPIS were positively correlated with the conventional inflammatory markers（ r = 0. 450,P =0.000）. Conclusion The simplified CPIS combined with PCT detection was helpful to improve the early diagnostic specificity of IPF complicated with pulmonary bacterial infection,and the sensitivity was not improved.

关 键 词：肺纤维化 细菌感染 C反应蛋白质 降钙素原 

分 类 号：R563.13[医药卫生—呼吸系统]