C反应蛋白对成人肺炎支原体肺炎的诊断价值研究  

Diagnostic value of C-reactive protein in Mycoplasma pneumoniae pneumonia in adults

作　　者：胡月 HU Yue(Department of Infectious Diseases,Beijing Huaxin Hospital,Beijing 100015,China)

机构地区：[1]北京华信医院感染性疾病科,100015

出　　处：《中国现代药物应用》2022年第7期1-5,共5页Chinese Journal of Modern Drug Application

摘　　要：目的分析成人肺炎支原体肺炎(MPP)的临床特征,并探讨C反应蛋白(CRP)对成人MPP的诊断价值。方法回顾性分析211例成人肺炎支原体(MP)感染患者的临床资料,按照胸部CT结果分为MPP组(42例)和除肺炎外呼吸道感染(RTIOP)组(169例)。对比两组的临床特征和实验室检查结果,分析成人MPP的临床特征及CRP对成人MPP的诊断效能。结果MPP组年龄、体温及咳嗽、胸痛、双肺呼吸音粗、干湿性啰音占比均高于RTIOP组,差异具有统计学意义(P<0.05);两组性别、发热、咽痛、恶心、腹泻、咽充血、扁桃体肿大情况对比差异无统计学意义(P>0.05)。MPP组中位CRP水平为52(31,91)mg/L,高于RTIOP组的12(6,31)mg/L,差异具有统计学意义(P<0.05);两组白细胞计数、中性粒细胞比例、中性粒细胞绝对值、降钙素原(PCT)、白细胞介素-6(IL-6)对比差异无统计学意义(P>0.05)。42例MPP患者主要以单肺病变为主,占71.4%,累及下叶占69.0%。实变、模糊影、磨玻璃影、树芽征占比分别为47.6%、35.7%、26.2%、16.7%。Logistic回归分析显示:血清CRP是MPP的独立危险因素(P<0.05)。受试者工作特征曲线(ROC)分析显示:血清CRP可作为诊断MPP的辅助临床标志物,曲线下面积(AUC)为0.83,血清CRP的最佳截断值为22.2 mg/L,灵敏度和特异度分别为89.7%和65.3%。结论对于MP感染患者,血清CRP≥22.2 mg/L可作为MPP区别于RTIOP的有效临床标志物,可能对一些临床和影像学不能与肺炎鉴别、无法或不适宜进行影像学检查的患者有一定的临床价值。Objective To analyze the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)in adults and discuss the diagnostic value of C-reactive protein(CRP)in adult MPP.Methods A total of 211 adult patients with Mycoplasma pneumoniae(MP)infection were divided into MPP group(42 cases)and respiratory tract infection other than pneumonia(RTIOP)group(169 cases)according to the results of chest CT.The clinical features and laboratory findings of the two groups were compared to analyze the clinical features of adult MPP and the diagnostic efficacy of CRP for adult MPP.Results The proportions of age,body temperature,cough,chest pain,coarse breath sounds in both lungs,dry and wet rales in the MPP group were higher than those in the RTIOP group,and the difference was statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of gender,fever,sore throat,nausea,diarrhea,pharyngeal congestion,and antiadoncus(P>0.05).The median CRP level in MPP group was 52(31,91)mg/L,which was higher than 12(6,31)mg/L in RTIOP group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in white blood cell count,neutrophil ratio,absolute value of neutrophils,procalcitonin(PCT)and interleukin-6(IL-6)between the two groups(P>0.05).42 cases of MPP were mainly single lung lesions,accounting for 71.5%,involving the lower lobe,accounting for 69.0%.Consolidation,blurred shadow,ground glass shadow,and tree bud sign accounted for 47.6%,35.7%,26.2%,and 16.7%,respectively.Logistic regression analysis showed that serum CRP was an independent risk factor for MPP(P<0.05).Receiver operating characteristic curve(ROC)analysis showed that serum CRP could be used as an adjunct clinical marker for the diagnosis of MPP,with an area under the curve(AUC)of 0.83 and an optimal cut-off value of 22.2 mg/L for serum CRP,with a sensitivity and specificity of 89.7%and 65.3%,respectively.Conclusion For patients with MP infection,serum CRP value≥22.2 mg/L may b

关 键 词：成人肺炎支原体肺炎 临床特征 C反应蛋白 

分 类 号：R563.1[医药卫生—呼吸系统]