s-ChE、PCT、CRP在肺结核合并肺部感染诊断及预后中的应用  

Application of S-ChE and PCT combined with CRP detection in the diagnosis and prognosis evaluation of pulmonary tuberculosis complicated with pulmonary infection

作　　者：党璋 吴琼 王娟[3] 王颖 DANG Zhang;WU Qiong;WANG Juan;WANG Ying(Department of Emergency Ward,Beijing Shijitan Hospital Affiliated to Capital Medical University,Beijing,China,100038;Department of General Neonatology,Children's Hospital Affiliated to Capital Institute of Pediatrics,Beijing,China,100020;Department of Neurosurgery,Beijing Fengtai YouAnMen Hospital,Beijing,China,100069;Department of General Clinic,Xinjiekou Community Health Service Center,Xicheng District,Beijing,China,100016)

机构地区：[1]首都医科大学附属北京世纪坛医院急诊病房,北京100038 [2]首都儿科研究所附属儿童医院普通新生儿外科,北京100020 [3]北京丰台右安门医院神经外科,北京100069 [4]北京市西城区新街口社区卫生服务中心全科门诊,北京100016

出　　处：《分子诊断与治疗杂志》2021年第5期786-789,共4页Journal of Molecular Diagnostics and Therapy

基　　金：北京市自然科学基金资助项目(Z161100000516006)。

摘　　要：目的探讨血清胆碱酯酶(S-ChE)、降钙素原(PCT)联合C-反应蛋白(CRP)检测在肺结核合并肺部感染诊断、预后评估中的应用。方法选择2018年6月至2020年5月本科室收治的110例肺结核患者作为研究对象,根据是否合并感染另分两个亚组:合并感染组(n=64),非合并感染组(n=46),同时纳入同期本院98例健康体检者作为对照组。比较各组S-ChE、PCT、CRP水平及各水平对检测肺结核合并肺部感染患者的灵敏度及特异度,并采用多元Logistic回归分析影响肺结核患者并发肺部感染的危险因素。结果两组患者S-ChE水平显著低于对照组,PCT、CRP、水平显著高于对照组,以合并感染组患者尤甚,差异均有统计学意义(P<0.05)。S-ChE、PCT、CRP灵敏度、特异度分别为89.06%、90.62%、92.18%、84.78%、86.95%、80.43%,而三者联合检测灵敏度、特异度高达93.75%、97.82%,其中,S-ChE+PCT+CRP联合检测特异度较S-ChE、PCT、CRP单独检测高(P<0.05)。合并感染组与非合并感染组年龄、是否长期使用糖皮质激素、肺部病变范围、S-ChE、PCT、CRP水平等比较差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:年龄、长期使用糖皮质激素、S-ChE、PCT、CRP水平为影响肺结核患者发生肺部感染的独立危险因素(P<0.05)。结论S-ChE、PCT联合CRP检测肺结核合并肺部感染具有一定诊断价值,临床工作者加强对其指标检测,具有一定借鉴作用。Objective To explore the application of serum cholinesterase(S-ChE)and procalcitonin(PCT)combined with C-reactive protein(CRP)detection in the diagnosis and prognosis evaluation of pulmonary tuberculosis complicated with pulmonary infection.Method The 110 pulmonary tuberculosis patients admitted to this department from June 2018 to May 2020 were selected as the research objects.According to whether the patients were combined with infection or not,they were divided into two subgroups:the co-infection group was set as group A(n=64),and the non-infection group was set as group B(n=46).At the same time,98 patients with normal physical examination results in this hospital were included as the control group.The levels of S-ChE,PCT and CRP in each group were compared and the sensitivity and specificity of each level in detecting patients with pulmonary tuberculosis complicated with pulmonary infection.Multivariate Logistic regression analysis was used to analyze the risk factors of pulmonary infection of patients with pulmonary tuberculosis.Result The S-ChE levels of patients in groups A and B were significantly lower than those in the control group,and the levels of PCT and CRP in A and B groups were significantly higher than those in the control group,especially in group A,and the differences were statistically significant(P<0.05).The sensitivity and specificity of S-ChE,PCT,and CRP are respectively 89.06%,90.62%,92.18%,and 84.78%,86.95%,and 80.43%,respectively,while the sensitivity and specificity of the combined detection of them were 93.75%and 97.82%.Among them,the specificity of the combined detection of S-ChE+PCT+CRP was higher than that of PCT,S-ChE,and CRP alone,and the difference was statistically significant(P<0.05).There were statistically significant differences between group A and group B in age,whether to use glucocorticoids for a long time,lung lesions,S-ChE,PCT,and CRP levels(P<0.05).Multivariate logistic regression analysis showed that age,long-term use of glucocorticoids,S-ChE,PCT,and CRP,levels were

关 键 词：S-ChE PCT CRP 肺结核合并肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统] R521[医药卫生—内科学]