血清N-末端脑钠肽前体、D-二聚体、降钙素原、C反应蛋白联合检测诊断慢性阻塞性肺疾病并发肺部感染的价值  

Significance of serum N-terminal pro-brain natriuretic peptide,D-dimer,procalcitonin and C-reactive protein in the diagnosis of chronic obstructive pulmonary disease complicated by pulmonary infection

作　　者：王静 陈颖 邵媛 Wang Jing;Chen Ying;Shao Yuan(Department of Clinical Laboratory,the Fifth People’s Hospital of Shangqiu,Shangqiu 476000,China)

机构地区：[1]商丘市第五人民医院检验科,商丘476000

出　　处：《中国实用医刊》2025年第2期79-82,共4页Chinese Journal of Practical Medicine

摘　　要：目的研究血清N-末端脑利钠肽前体(NT-proBNP)、D-二聚体(D-D)、降钙素原(PCT)、C反应蛋白(CRP)联合检测诊断慢性阻塞性肺疾病(COPD)并发肺部感染的价值。方法回顾性抽取2021年1月至2022年12月商丘市第五人民医院收治的82例COPD患者作为研究对象,按是否并发肺部感染分为并发感染组(49例)和非并发感染组(33例),并以相同比例抽取于医院体检健康者82例作为健康组。检测并比较3组NT-proBNP、D-D、PCT、CRP水平,统计各指标联合诊断COPD并发肺部感染的诊断结果和诊断效能,分析预测值。结果并发感染组和非并发感染组NT-proBNP、D-D、PCT、CRP水平高于健康组(P<0.05),且并发感染组NT-proBNP、D-D、PCT、CRP水平高于非并发感染组(P<0.05)。49例COPD并发肺部感染患者和115例非肺部感染者中,经NT-proBNP检测出真阳性38例,真阴性85例;D-D检测出真阳性35例,真阴性87例;PCT检测出真阳性29例,真阴性101例;CRP检测出真阳性37例,真阴性83例;四者联合检测出真阳性47例,真阴性113例。四者联合诊断灵敏度、特异度、准确度高于NT-proBNP、D-D、PCT、CRP诊断(P<0.05),漏诊率、误诊率低于NT-proBNP、D-D、PCT、CRP诊断(P<0.05);四者联合诊断阳性预测值、阴性预测值高于NT-proBNP、D-D、PCT、CRP诊断(P<0.05)。结论NT-proBNP、D-D、PCT、CRP在COPD并发肺部感染患者血清中的表达水平较高,四者联合诊断COPD并发肺部感染可明显提升诊断效能和阳性预测值,减少漏诊事件的发生。Objective To investigate the significance of combined detection of serum N-terminal pro-brain natriuretic peptide(NT-proBNP),D-dimer(D-D),procalcitonin(PCT)and C reactive protein(CRP)in the diagnosis of chronic obstructive pulmonary disease(COPD)complicated by pulmonary infection.Methods Eighty-two COPD patients admitted to the Fifth People’s Hospital of Shangqiu from January 2021 to December 2022 were retrospectively selected as the research subjects,and they were divided into a concurrent infection group(49 cases)and a non concurrent infection group(33 cases)based on development of pulmonary infection.Eighty-two healthy individuals who underwent physical examinations in the hospital were selected as the health group in the same proportion.The levels of NT-proBNP,D-D,PCT and CRP of the three groups were detected,and the detection results were compared.The results and efficacy of the combined detection of the above indicators in the diagnosis of COPD with pulmonary infection were analyzed,and the predictive value was analyzed.ResultsThe levels of NT-proBNP,D-D,PCT,and CRP in the concurrent infection group and non concurrent infection group were higher than those in the health group(P<0.05);and the levels of NT-proBNP,D-D,PCT,and CRP in the concurrent infection group were higher compared with the non concurrent infection group(P<0.05).Among the 49 COPD patients with concurrent pulmonary infections and 115 COPD patients without pulmonary infections,NT-proBNP detected out 38 true-positive cases and 85 true-negative cases;D-D testing detected out 35 true-positive cases and 87 true-negative cases;PCT testing detected out 29 true-positive cases and 101 true-negative cases;CRP testing detected out 37 true-positive cases and 83 true-negative cases;the combination of the four indicators detected out 47 true-positive cases and 113 true negative cases.The sensitivity,specificity,and accuracy of the combined diagnosis of NT-proBNP,D-D,PCT,and CRP were higher than the four single-indicator testings(P<0.05),while the missed

关 键 词：慢性阻塞性肺疾病 肺部感染 N-末端脑利钠肽前体 D-二聚体 降钙素原 

分 类 号：R54[医药卫生—心血管疾病]