【摘要】 目的探讨降钙素原(PCT)测定在肺炎患者临床诊断的价值。方法将117例发热、胸痛、咳痰等疑为肺炎的患者作为观察对象,同时作胸腔X光、CT检查等影像学检查和PCT、超敏C反应蛋白(CRP)、WBC计数等检测,以影像学检查结果为金标准,比较PCT、CRP、WBC计数在该诊断中的准确性、特异性、阴性及阳性预测值。结果 117例患者中胸腔影像学检查肺部出现阳性结果 59例,PCT增高88例,CRP增高66例,WBC增高60例;其敏感度和特异性分别为83.05%和44.83%,81.36%和77.59%,66.10%和74.14%。PCT联合CRP应用敏感度和特异性分别为93.22%和41.38%,PCT联合WBC计数应用敏感度和特异性分别为89.83%和31.03%;按串联试验计算其敏感度和特异性分别67.60%和87.64%,54.9%和85.73%。把PCT阳性阈值提高至0.25 ng/ml以上时,敏感度和特异性分别33.90%和84.48%。结论 PCT、CRP、WBC计数是肺炎患者感染的诊断重要参考指标,PCT对感染诊断具有较强的敏感性,当把阳性阈值提高时特异性亦较高,联合应用可提高诊断的敏感度和特异性。更多还原

【Abstract】 Objective To investigate the value of serum procalcitonin( PCT) for estimation of clinical diagnosis in the patients with pneumonia. Methods 117 pneumonia suspected cases with fever,chest pain and a cough which produce sputum were selected for observation. The patients then took X-ray and CT imaging examination,and the result were used as the gold standard. Testing PCT,CRP and WBC of patients,then the sensitive and specific of the three detection index were compared in the diagnosis of pneumonia. Results 59 cases were positive with imaging examination,PCT increased in 88 cases,CRP increased in 66 cases,and WBC increased in 60 cases. The sensitivity and specificity were 83. 05% and 44. 83%,81. 36% and 77. 59%,66. 10% and 74. 14% respectively. The sensitivity and specificity of PCT and CRP were 93. 22% and 41. 38%respectively,the sensitivity and specificity of PCT and WBC were 89. 83% and 31. 03% respectively. The sensitivity and specificity were 67. 60% and 87. 64%,54. 9% and 85. 73% respectively,by calculating on series of test. When increase the PCT positive threshold up to 0. 25 ng / ml,the sensitivity and specificity were 33. 90%and 84. 48%,respectively. Conclusions Detecting serum PCT,CRP and WBC were important reference indexes to diagnose pneumonia,and PCT has the highest sensitivity and specificity. When increased the positive threshold of PCT and joint applicated CRP or WBC,the sensitivity and specificity of diagnosis could be improved.更多还原