降钙素原测定对重症肺炎并脓毒性休克早期诊断的临床价值  

The clinical value of procalcitonin determination in the early diagnosis of severe pneumonia and septic shock

作　　者：曾菁 黎宝红 潘文英 ZENG Jing;LI Bao-hong;PAN Wen-ying(Department of Critical Care Medicine,Liwan District People's Hospital,Guangzhou 510000,China)

机构地区：[1]广州市荔湾区人民医院重症医学科,510000

出　　处：《中国实用医药》2020年第34期18-20,共3页China Practical Medicine

摘　　要：目的探究降钙素原(PCT)测定对重症肺炎并脓毒性休克早期诊断的临床价值。方法 103例重症肺炎并休克患者为研究样本,根据是否存在脓毒性休克分为非脓毒性休克组(53例)以及脓毒性休克组(50例)。在受试者出现休克首日,采集其血液样本,测定乳酸、C-反应蛋白(CRP)以及PCT水平,同时开展血培养。对比两组患者的PCT检测结果 ,不同血培养结果患者的PCT检测结果,两组患者的PCT、CRP乳酸水平。结果脓毒性休克组和非脓毒性休克组患者的PCT检测结果对比,差异具有统计学意义(P<0.05)。脓毒性休克组患者的PCT水平≥5.1 ng/ml,非脓毒性休克组患者的PCT水平≤2.0 ng/ml。血培养结果显示阳性43例,阴性60例。不同血培养结果患者的PCT检测结果对比,差异具有统计学意义(P<0.05)。血培养阳性患者的PCT水平≥5.1 ng/ml,血培养阴性患者的PCT水平≤2.0 ng/ml。脓毒性休克组患者的PCT(14.06±2.33)ng/ml显著高于非脓毒性休克组的(1.26±0.48)ng/ml,差异具有统计学意义(P<0.05)。两组患者的CRP、乳酸水平对比,差异均无统计学意义(P>0.05)。结论重症肺炎合并脓毒性休克患者开展PCT测定其灵敏度明显比血培养更高。对于该疾病患者的早期诊断以及治疗有着相当重要的指导意义,因此值得进一步在临床中推广以及应用。Objective To investigate the clinical value of procalcitonin(PCT) determination in the early diagnosis of severe pneumonia and septic shock. Methods A total of 103 patients with severe pneumonia and septic shock as study subjects were divided into non-septic shock group(53 cases) and septic shock group(50 cases) according to the presence or absence of septic shock. On the first day of shock, blood samples were collected to determine the levels of lactate, C-reactive protein(CRP), and PCT, and blood cultures were performed. Comparison was made on PCT test results of the two groups, PCT test results of the patients with different blood culture results, and the PCT and CRP lactate levels of the two groups. Results There was statistically significant difference in PCT test results between non-septic shock group and septic shock group(P<0.05). The PCT level of patients in the septic shock group was ≥ 5.1 ng/ml, and those was ≤2.0 ng/ml in the non-septic shock group. The blood culture results showed positive in 43 cases and negative in 60 cases. There was statistically significant difference in PCT test results of the patients with different blood culture results(P<0.05). The PCT level of patients with positive blood culture was ≥ 5.1 ng/ml, and that was ≤2.0 ng/ml of patients with negative blood culture. The PCT(14.06±2.33) ng/ml in the septic shock group was significantly higher than(1.26±0.48) ng/ml in the non-septic shock group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in CRP and lactic acid between the two groups(P>0.05). Conclusion The sensitivity of PCT determination in patients with severe pneumonia combined with septic shock is significantly higher than that of blood culture, which has very important guiding significance for the early diagnosis and treatment of patients. Therefore, it is worthy of further promotion and application in clinical practice.

关 键 词：降钙素原 重症肺炎 脓毒性休克 早期诊断 价值分析 

分 类 号：R563.1[医药卫生—呼吸系统] R459.7[医药卫生—内科学]