降钙素原检测用于AECOPD患者病原菌分类及预后评估中的临床价值  

Clinical Value of Procalcitonin Detection in the Classification and Prognosis of Pathogenic Bacteria in Patients with AECOPD

作　　者：谢效兵 陈世佳 XIE Xiao-bing;CHEN Shi-jia(Clinical Laboratory,Pingdingshan Medical District,989th Hospital of PLA Joint Logistics Support Force,Pingdingshan 467000,Henan Province,China)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院平顶山医疗区检验科,河南平顶山467000

出　　处：《罕少疾病杂志》2024年第7期32-34,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的分析降钙素原检测用于慢性阻塞性肺疾病急性加重(AECOPD)患者病原菌分类及预后评估中的临床价值。方法选取我院2021年1月至2023年3月期间收治的150例AECOPD患者,均在入院24 h内检测PCT水平,通过痰培养分离病原菌种类,分析不同病原菌感染组患者降钙素原水平;并对患者预后结局进行分组,比较不同组别患者降钙素原水平。结果革兰阴性菌感染者血清PCT水平明显高于革兰阳性菌、真菌组(P<0.05),其中革兰阴性菌中,肺炎克雷伯菌PCT水平越高,其次是流感嗜血杆菌;革兰阳性菌中,金黄色葡萄球菌PCT水平越高(P<0.05)。预后良好组PCT水平、SOFA评分、APACHEⅡ评分低于预后不良组(P<0.05)。PCT结合SOFA评分、APACHEⅡ评分预测患者预后不良的灵敏度100.00%、特异度95.00%均高于单项指标(P<0.05)。结论降钙素原检测可作为AECOPD患者病原菌分类的辅助指标,对预测患者预后也有一定价值。Objective To analyze the clinical value of procalcitonin detection in the classification and prognosis evaluation of pathogens in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 150 patients with AECOPD admitted to our hospital from January 2021 to March 2023 were selected and the PCT levels were detected within 24 h of admission,pathogenic bacteria species were isolated by sputum culture,and the procalcitonin levels of patients in different pathogenic bacterial infection groups were analyzed.Patients were grouped for prognostic outcomes,and procalcitonin levels were compared between different groups.Results The serum PCT level of Gram-negative bacteria was significantly higher than that of Gram-positive bacteria and fungal group(P<0.05),among which the PCT level of Klebsiella pneumoniae was higher among Gram-negative bacteria,followed by Haemophilus influenzae,and the PCT level of Staphylococcus aureus was higher among Gram-positive bacteria(P<0.05).The PCT level,SOFA score,and APACHEII.score in the good prognosis group were lower than those in the poor prognosis group(P<0.05).The sensitivity of PCT combined with SOFA score and APACHEII.score to predict poor prognosis of patients was 100.00%and specificity of 95.00%were higher than those of individual indexes(P<0.05).Conclusion Procalcitonin detection can be used as an auxiliary index for the classification of pathogenic bacteria in patients with AECOPD,and it also has certain value in predicting the prognosis of patients.

关 键 词：降钙素原 AECOPD 病原菌 预后 

分 类 号：R563.9[医药卫生—呼吸系统]