PCT在慢性肝炎合并肺部感染患者中的诊断价值  

Diagnostic value of procalcitonin in patients with chronic hepatitis combined with lung infections

作　　者：徐小杰[1] 黄磊[1] 郑文龙[1] 任自力[1] 庄锦娟[1] XU Xiao-jie HUANG Lei ZHENG Wen-long REN Zi-li ZHUANG Jin-juan(Hangzhou Traditional Chinese Medical Hospital of Zhejiang Province, Hangzhou, Zhejiang 310007, China)

机构地区：[1]杭州市中医院感染性疾病科,浙江杭州310007

出　　处：《中华医院感染学杂志》2016年第23期5358-5360,5378,共4页Chinese Journal of Nosocomiology

基　　金：2014年浙江省医药卫生科技一般计划(2014KYA185)

摘　　要：目的探讨降钙素原（PCT）在慢性肝炎合并肺部感染患者中的诊断价值,为临床治疗提供参考依据。方法回顾性收集2012年1月-2016年1月医院收治的慢性肝炎患者156例,根据患者是否发生肺部感染,将患者分为肺部感染组65例和无感染组91例,比较两组患者临床指标,分析PCT在诊断患者肺部感染中的价值。结果与无肺部感染患者相比,肺部感染组患者PCT、白细胞、中性粒细胞、C-反应蛋白、APACHEⅡ评分、SOFA评分、乳酸水平、乳酸脱氢酶、总胆红素、凝血酶原活动度显著增高,白蛋白、谷丙转氨酶水平显著降低,随着PCT浓度梯度的增加,肺部感染率显著增加,差异均有统计学意义（P〈0.05）;PCT在诊断慢性肝炎患者肺部感染的曲线下面积高达0.979,95%可信区间为0.955~1.000。结论 PCT在慢性肝炎患者肺部感染中具有较好的临床价值。OBJECTIVE To investigate the diagnostic value of procalcitonin（PCT）in patients with chronic hepatitis combined with lung infections,so as to provide evidence for clinical treatment.METHODS From Jan.2012 to Jan.2016,156 patients with chronic hepatitis were enrolled in this retrospective study.All patients were divided into pulmonary infection group（n=65）and pulmonary non-infection group（n=91）,according to whether patients with pulmonary infection.The clinical indexes of the two groups were compared.Moreover,the diagnosis value of PCT in patients with pulmonary infection was analyzed as well.RESULTS When compared with pulmonary non-infection patients,patients in pulmonary infection group got significantly higher levels of PCT,white blood cell,neutrophile granulocyte,C reactive protein,APACHEⅡ score,SOFA score,lactate,lactate dehydrogenase,total bilirubin and prothrombin activity,and significantly lower levels of albumin and glutamic-pyruvic transaminase.As the level of PCT increased,the rate of pulmonary infection increased,with significant difference（P〈0.05）.The area under curve of PCT in the diagnosis of lung infection in patients with chronic hepatitis was 0.979（95%CI：0.955~1.000）.CONCLUSIONPCT shows a better diagnostic value in pulmonary infection in patients with chronic hepatitis.

关 键 词：降钙素原 肝炎 肺部感染 诊断价值 

分 类 号：R512.6[医药卫生—内科学]