PCT、HBP、SAA对重症病毒性肺炎继发细菌感染患者的诊断价值  

Diagnostic value of PCT,HBP,and SAA in patients with bacterial infection secondary to severe viral pneumonia

作　　者：才莹 谢凤杰 孙宇 张虹 赵文瑞 李洁 于得泓 王德平 李海红 CAI Ying;XIE Fengjie;SUN Yu;ZHANG Hong;ZHAO Wenrui;LI Jie;YU Dehong;WANG Deping;LI Haihong(Department of Critical Care Medicine,Hongqi Hospital Affiliated to Mudanjiang Medical University,Heilongjiang,Mudanjiang 157000,China;Department of Hematology,Hongqi Hospital Affiliated to Mudanjiang Medical University,Heilongjiang,Mudanjiang 157000,China;Department of Rheumatology and Immunology,Hongqi Hospital Affiliated to Mudanjiang Medical University,Heilongjiang,Mudanjiang 157000,China;Department of Endocrinology,Hongqi Hospital Affiliated to Mudanjiang Medical University,Heilongjiang,Mudanjiang 157000,China)

机构地区：[1]牡丹江医学院附属红旗医院重症医学科,黑龙江牡丹江157000 [2]牡丹江医学院附属红旗医院血液科,黑龙江牡丹江157000 [3]牡丹江医学院附属红旗医院风湿免疫科,黑龙江牡丹江157000 [4]牡丹江医学院附属红旗医院内分泌科,黑龙江牡丹江157000

出　　处：《中国医药科学》2023年第23期177-180,共4页China Medicine And Pharmacy

基　　金：黑龙江省卫生健康委科研课题(2020-405)。

摘　　要：目的探讨降钙素原(PCT)、肝素结合蛋白(HBP)、血清淀粉酶样蛋白A(SAA),检测对病毒性肺炎患者继发细菌感染的诊断价值。方法选取2022年1月至2023年4月牡丹江医学院附属红旗医院、康安医院住院的肺部感染患者93例,将以上患者按临床表现及实验室检测分为细菌感染组30例,混合感染组34例(病毒感染继发细菌感染患者),病毒感染组29例。比较三组患者一般资料、血清因子水平、不同感染类型血清因子水平及各项检测方法诊断价值。结果三组患者性别、年龄、体重指数(BMI)、急性生理与慢性健康评分系统(APACHEⅡ)评分比较,差异无统计学意义(P>0.05);混合感染患者血清PCT、HBP、SAA水平均高于细菌感染及病毒感染患者,差异有统计学意义(P<0.05)。细菌感染组及混合感染组PCT、HBP在血清中水平均显著高于病毒感染组,差异有统计学意义(P<0.05);而病毒感染组SAA在血清中水平高于细菌感染组,差异有统计学意义(P<0.05);SAA对于混合感染组患者的特异度及敏感度均较高,其次,PCT及HBP均具有较高的灵敏度及特异度,其中PCT预测价值更高,差异有统计学意义(P<0.05)。结论血清PCT、HBP、SAA在肺部感染性疾病中均具有一定诊断价值,可为临床诊断及治疗提供参考依据。Objective To explore the diagnostic value of procalcitonin(PCT),heparin-binding protein(HBP),and serum amyloid-like protein A(SAA)tests for secondary bacterial infections in patients with viral pneumonia.Methods A total of 93 pulmonary infection patients admitted to Hongqi Hospital and Kang’an Hospital Affiliated to Mudanjiang Medical University from January 2022 to April 2023 were selected.The above patients were divided into a bacterial infection group of 30 cases,a mixed infection group of 34 cases(patients with bacterial infection secondary to severe viral pneumonia),and a viral infection group of 29 cases based on clinical manifestations and laboratory tests.The general information,serum factor levels,serum factor levels of different infection types,and diagnostic value of various test methods among the three groups of patients were compared.Results There was no statistically significant difference in clinical data such as gender,age,body mass index and acute physiology and chronic health evaluation(APACHEⅡ)score among the three groups of patients(P>0.05).The levels of PCT,HBP,and SAA in serum in patients with mixed infection were higher than those in patients with bacterial and viral infections,with statistically significant differences(P<0.05).The levels of PCT and HBP in serum in the bacterial infection group and mixed infection group were significantly higher than those in the viral infection group,with statistically significant differences(P<0.05).The levels of SAA in serum in the viral infection group were higher than those in the bacterial infection group,with statistically significant difference(P<0.05).The specificity and sensitivity of SAA for patients in the mixed infection group were higher.Secondly,both PCT and HBP had higher sensitivity and specificity,and PCT had higher predictive values,with statistically significant differences(P<0.05).Conclusion PCT,HBP and SAA in serum have certain diagnostic values in pulmonary infectious diseases and can provide a reference for clinical diagnosis and

关 键 词：病毒性肺炎 细菌性感染 降钙素原 肝素结合蛋白 血清淀粉酶样蛋白A 诊断价值 

分 类 号：R563.1[医药卫生—呼吸系统]