肺泡灌洗液降钙素原在重症肺炎中的诊断价值  

Diagnostic Value of Procalciton in Bronchoalveolar Fluid in Severe Pneumonia

作　　者：兰博 蓝桂伍 黄华田[2] 陈烁名 林春燕[1] LAN Bo;LAN Gui-wu;HUANG Hua-tian;CHEN Shuo-ming;LIN Chun-yan(Department of Clinical Pharmacy,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China;Department of Intensive Care Unit,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China)

机构地区：[1]广西壮族自治区江滨医院临床药学科,广西南宁530021 [2]广西壮族自治区江滨医院重症医学科,广西南宁530021

出　　处：《医学信息》2023年第11期145-148,共4页Journal of Medical Information

基　　金：广西卫健委自筹经费科研课题(编号:Z20210351);广西医疗卫生适宜技术开发与推广应用项目(编号:S2018002)。

摘　　要：目的探索重症肺炎患者血清及肺泡灌洗液(BALF)的降钙素原(PCT)浓度及其临床价值。方法选取2019年10月-2020年10月广西壮族自治区江滨医院ICU收治的重症肺炎患者108例患者作为研究对象,根据其肺部感染的严重程度分为重症肺炎组(51例)与肺炎组(57例),比较两组血清、BALF的PCT值及重症肺炎组不同病原微生物BALF的PCT值,使用接受者操作特征曲线(ROC曲线)评估血清及BALF的PCT对重症肺炎的早期诊断价值。结果重症肺炎组血清及BALF的PCT值均高于肺炎组(P<0.05);G^(-)杆菌引起的肺部感染BALF的PCT值高于G^(+)球菌及真菌(P<0.05),而G^(+)球菌及真菌引起的肺部感染BALF的PCT值比较,差异无统计学意义(P>0.05);血清及BALF的PCT值对早期重症肺炎均具有较高的诊断效能(AUC=0.948、0.850),其截断值分别为4.50 ng/ml及1.75 ng/ml。结论BALF的PCT值在重症肺炎的早期诊断中具有重要参考价值。Objective To explore the concentration and clinical value of procalcitonin(PCT)in serum and bronchoalveolar lavage fluid(BALF)of patients with severe pneumonia.Methods A total of 108 patients with severe pneumonia admitted to ICU of Jiangbin Hospital of Guangxi Zhuang Autonomous Region from October 2019 to October 2020 were selected as the research objects.According to the severity of pulmonary infection,they were divided into severe pneumonia group(51 cases)and pneumonia group(57 cases).The PCT values of serum and BALF in the two groups and the PCT values of BALF of different pathogenic microorganisms in the severe pneumonia group were compared.The receiver operating characteristic curve(ROC curve)was used to evaluate the early diagnostic value of PCT in serum and BALF for severe pneumonia.Results The PCT values of serum and BALF in severe pneumonia group were higher than those in pneumonia group(P<0.05).The PCT value of BALF in pulmonary infection caused by G^(-) bacilli was higher than that of G^(+) cocci and fungi(P<0.05),but there was no significant difference in PCT value of BALF in pulmonary infection caused by G^(+) cocci and fungi(P>0.05).The PCT values of serum and BALF had high diagnostic efficacy for early severe pneumonia(AUC=0.948,0.850),and the cutoff values were 4.50 ng/ml and 1.75 ng/ml,respectively.Conclusion The PCT value of BALF has important reference value in the early diagnosis of severe pneumonia.

关 键 词：肺泡灌洗液 降钙素原 重症肺炎 重症医学科 

分 类 号：R563.1[医药卫生—呼吸系统]