血清CRP、PCT和乳酸对老年肺部感染患者预后的临床价值  

Clinical value of serum CRP, PCT and lactic acid in diagnosis of prognosis of elderly patients with pulmonary infection

作　　者：季金芳[1] 孟海艳[1] 施金梅 许惠芬[1] JI Jin-fang;MENG Hai-yan;SHI Jin-mei;XU Hui-fen(Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China)

机构地区：[1]南通大学附属医院重症医学科,江苏南通226001 [2]南通大学附属医院呼吸监护科,江苏南通226001

出　　处：《中华医院感染学杂志》2020年第17期2628-2631,共4页Chinese Journal of Nosocomiology

基　　金：江苏省自然科学基金资助项目(2019489)。

摘　　要：目的 探究血清CRP、PCT和乳酸对老年肺部感染患者预后的诊断价值.方法 选取2017年1月-2019年1月南通大学附属医院重症医学科收治的老年肺部感染患者76例作为研究组.同期未发生肺部感染40例患者作为对照组.观察感染患者血清CRP、PCT和乳酸水平变化,并采用受试者工作特征(ROC)曲线分析血清CRP、PCT和乳酸对老年肺部感染患者预后的价值.结果 研究组患者血清CRP(15.81±1.84) mg/L、PCT(35.45±10.59)μg/ml及乳酸(4.02±1.17)mmol/L均高于对照组,差异有统计学意义(P<0.05).研究组中死亡亚组患者血清CRP、PCT及乳酸水平均高于存活亚组(P<0.05).血清CRP、PCT及乳酸对于老年肺部感染患者预后均具有一定的诊断价值(P<0.05),且联合检测的特异性、灵敏度、阳性预测值及阴性预测值更高(P<0.05).结论 老年肺部感染患者血清CRP、PCT和乳酸均升高,三项指标联合检测对老年肺部感染患者预后具有较高的诊断价值.OBJECTIVE To explore the value of serum CRP,PCT and lactic acid in diagnosis of prognosis of elderly patients with pulmonary infection.METHODS Totally 76 elderly patients with pulmonary infection who were treated in critical medicine department of Affiliated Hospital of Nantong University from Jan 2017 to Jan 2019 were chosen as the study group,meanwhile,40 patients who did not have pulmonary infection were set as the control group.The changes of levels of serum CRP,PCT and lactic acid of the patients with infection were observed,and the value of the serum CRP,PCT and lactic acid in diagnosis of the prognosis of the elderly patients with pulmonary infection was analyzed by using receiver-operating-characteristic(ROC)curve.RESULTS The levels of serum CRP,PCT and lactic acid of the study group were respectively(15.81±1.84)mg/L,(35.45±10.59)μg/ml and(4.02±1.17)mmol/L,significantly higher than those of the control group(P<0.05).In the study group,the levels of serum CRP,PCT and lactic acid of the death subgroup were significantly higher than those of the survival subgroup(P<0.05).The serum CRP,PCT and lactic acid had certain value in diagnosis of the prognosis of the elderly patients with pulmonary infection(P<0.05),and the specificity,sensitivity,positive predictive value and negative predictive value of the joint detection were even significantly higher(P<0.05).CONCLUSION The levels of serum CRP,PCT and lactic acid of the elderly patients with pulmonary infection are elevated,the joint detection of the three indexes has high value in diagnosis of the prognosis of the elderly patients with pulmonary infection.

关 键 词：肺部感染 C-反应蛋白 降钙素原 乳酸 临床价值 

分 类 号：R563.1[医药卫生—呼吸系统]