贵州医科大学学报

2016, v.41;No.192(09) 1104-1107

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血乳酸、PCT及CRP对老年肺炎的诊断价值
Value of Blood Lactate,PCT and CRP in Diagnosis of Elderly Pneumonia

黄辉如;
HUANG Huiru;Laboratory Medicine,Central People's Hospital of Huizhou City;

摘要(Abstract):

目的:探讨血清乳酸、降钙素原(PCT)及C反应蛋白(CRP)在老年肺炎中的诊断价值。方法:选择85例经细菌培养确诊为肺部感染的老年患者为观察组,同期80例健康体检者为对照组,观察组于入院次日抽取静脉血5 m L,对照组于体检当天抽取静脉血5 m L,应用免疫荧光分析法测定血清PCT水平,应用全自动化生化分析仪测定两组血清乳酸,应用散射比浊法测定两组血清CRP水平,比较两组受检者血乳酸、PCT、CRP水平;比较老年肺炎治疗7 d时死亡病例和存活病例血清乳酸、PCT、CRP水平;绘制受试者工作曲线(ROC),观察血清乳酸、PCT、CRP联合检测对老年肺炎的诊断价值。结果:观察组血乳酸、PCT、CRP水平显著高于对照组(P<0.05);与存活病例相比,死亡病例血清乳酸、PCT、CRP水平较高(P<0.05);经ROC分析显示,血清乳酸、PCT、CRP联合检测时灵敏性、特异性高于各单项检测(P<0.05)。结论:血乳酸、PCT、CRP水平可作为老年肺炎患者病情预后的评价指标;通过联合检测可提高血乳酸、PCT、CRP的在老年肺炎中的诊断效能。
Objective: To investigate the value of blood lactate,procalcitonin( PCT) and C-reactive protein( CRP) in diagnosis of patients with pneumonia. Methods: 85 cases of pulmonary infection in elderly patients were selected as observation group and 80 cases of normal physical examination volunteers were selected as control group. 5 m L venous blood was taken in observation group on the next day of hospitalization while 5 m L venous blood was taken in control group on the day of physical examination. The levels of PCT of two groups were determined by immunofluorescence assay,the levels of blood lactate of two groups were determined by fully automated biochemistry,and the levels of CRP of two groups were determined by scattering nephelometry. Blood lactic acid,PCT and CRP levels were compared between the observation group and the control group. The patients were divided into death group and survival group according to the treatment outcome and the blood lactic acid,PCT and CRP levels were compared between the two groups. The receiver operating curve( ROC) was drawn and the diagnostic value of combination detection of blood lactic acid,PCT and CRP in detection of pneumonia in the elderly people was observed. Results: The levels of blood lactate,PCT and CRP of observation group were significantly higher than those of control group( P < 0. 05). The levels of blood lactate,PCT and CRP of death group were significantly higher than those of survival group( P < 0. 05).Through ROC analysis,the sensitivity,specificity of combination detection of blood lactate,PCT and CRP significantly were higher than the individual detection( P < 0. 05). Conclusion: Blood lactate,PCT and CRP levels can be used as evaluating indicators of prognosis in elderly patients with pneumonia. The joint detection can improve diagnostic efficiency of blood lactate,PCT and CRP value in elderly pneumonia.

关键词(KeyWords): 乳酸;降钙素原;C反应蛋白;老年人;肺炎
lactate;procalcitonin;C-reactive protein;elderly;pneumonia

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作者(Author): 黄辉如;
HUANG Huiru;Laboratory Medicine,Central People's Hospital of Huizhou City;

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