社区获得性肺炎患者血清高敏C反应蛋白、肌钙蛋白I和D-二聚体水平的临床分析  

Clinical Analysis of Serum hs-CRP, cTnI and D-D Levels in the Patients with Community Acquired Pneumonia

作　　者：李宁[1] 徐莉[1] 陈颖[1] 徐国鹏[1] 

机构地区：[1]南京医科大学附属苏州医院、苏州市立医院本部呼吸内科,江苏苏州215002

出　　处：《中国血液流变学杂志》2016年第1期50-52,128,共4页Chinese Journal of Hemorheology

摘　　要：目的：探讨社区获得性肺炎（community acquired pneumonia, CAP）患者血清高敏C反应蛋白（high-sensitivity C-reactive protein, hs-CRP），肌钙蛋白I（cardiac troponin I, cTnI）和D-二聚体（D-dimer, D-D）水平的临床意义。方法133例CAP患者经细菌培养分成63例革兰阴性菌感染组、39例革兰阳性菌感染组和31例真菌感染组。采用放射免疫分析、化学发光免疫分析和免疫比浊分析分别测定133例CAP患者和60例对照组血清hs-CRP、cTnI和D-D水平，并进行对比性研究。结果 CAP患者血清hs-CRP水平显著高于对照组（P＜0.001），其中革兰阴性菌感染组血清hs-CRP水平显著高于革兰阳性菌感染组和真菌感染组（P＜0.05，P＜0.01），革兰阳性菌感染组血清hs-CRP水平显著高于真菌感染组（P＜0.05），故血清hs-CRP水平具有病原体早期诊断和鉴别诊断临床价值。CAP患者血清cTnI和D-D水平显著高于对照组（P＜0.001，P＜0.01），革兰阴性菌感染组血清cTnI和D-D水平显著高于真菌感染组（P均＜0.05），而革兰阳性菌感染组较之真菌感染组差异无统计学意义（P＞0.05）。结论血清hs-CRP、cTnI和D-D水平是早期诊断CAP患者的有价值指标，病原体的鉴别诊断以血清hs-CRP水平为好。Objective To explore the clinical value of serum hs-CRP, cTnI and D-D levels in the patients with community acquired pneumonia （CAP）.Methods 133 patients with CAP of bacterial strain infection were divided into 3 groups, 63 with gram negative bacterial strains infection, 39 with gram positive bacterial strains infection and 31 with strains fungi infection. The serum hs-CRP, cTnI and D-D levels in 133 patients with CAP and 60 healthy controls were determined by radioimmunoassay, chemiluminescence immunoassay and immunoturbidimetry with compared analysis.Results The serum hs-CRP level in CAP patients was signiifcantly higher than those in control group （P〈0.001）, the serum hs-CRP level in gram negative bacterial strains infection group was higher than those in gram positive bacterial strains infection group and strains fungi infection group （P〈0.05,P〈0.01）. The serum hs-CRP level in gram positive bacterial strains infection group was higher than those in strains fungi infection group （P〈0.05） so that the serum hs-CRP possessed early identiifcation diagnosis forbacterial strains. The serum cTnI and D-D levels in CAP patients were signiifcantly higher than those in control group （P〈0.001 and〈0.01）. The serum cTnI and D-D levels in gram negative bacterial strains infection group were higher than those in gram positive bacterial strains infection group and strains fungi infection group （P all〈0.05）, but there was no signiifcant difference between gram positive bacterial strains infection group and strains fungi infection group （P〉0.05）.Conclusion The serum hs-CRP, cTnI and D-D levels in CAP patients were a valuable index for early diagnosis, but the serum hs-CRP was best in identiifcation diagnosis of bacterial strains.

关 键 词：社区获得性肺炎(CAP) 病原体 高敏-C反应蛋白(hs-CRP) 早期诊断 鉴别诊断 

分 类 号：R563.1[医药卫生—呼吸系统]