血清降钙素原变化率测定对重症肺炎患者预后的判断价值

目的 探讨降钙素原（PCT）变化率测定对重症肺炎患者预后的判断价值.方法 选取住院肺炎患者98例,重症肺炎组50例,轻症肺炎组48例.动态观察其血清PCT、血常规、C反应蛋白（CRP）及白细胞介素（IL）-6浓度的变化情况.记录重症肺炎组患者的住院时间、机械通气比率及病死率.结果 重症肺炎组患者血清PCT及CRP水平均明显高于轻症肺炎组（19.8±21.6）μg/比（1.5±0.8） μg/L,（34.3±13.1） ng/L比（11.5±5.2） ng/L],差异有统计学意义（P＜0.05）;而两组患者白细胞计数（WBC）、IL-6等比较差异无统计学意义（P＞0.05）.重症肺炎患者血清PCT随着病情被有效控制而迅速下降,WBC、CRP及IL-6一直维持在较高水平;CRP下降幅度（10.3±7.8）％,IL-6下降幅度（12.4±6.9）％,PCT下降幅度（43.5±12.3）％,差异有统计学意义（P＜0.05）.结论 较传统炎性指标WBC、CRP及IL-6而言,PCT更能协助对感染的诊断,且其变化率对判断重症肺炎患者预后有一定的临床价值.

Evaluation value of serum procalcitonin change rate determination on the prognosis of patients with severe pneumonia

Objective To investigate the evaluation value of serum procalcitonin（PCT） change rate determination on the prognosis of patients with severe pneumonia.Methods A total of 98 patients with pneumonia,patients were selected and divided into severe pneumonia group （50 cases） and mild pneumonia group （48 cases）.The changes of serum PCT,blood routine,C reactive protein （CRP） and interleukin （IL）-6 concentration were observed dynamicly.The severe pneumonia hospitalization time,mechanical ventilation rate and mortality rate was recorded.Results The serum PCT and CRP levels in severe pneumonia group were significantly higher than those in mild pneumonia group （19.8 ± 21.6） μ g/L vs.（1.5 ± 0.8） μ g/L,（34.3 ± 13.1） ng/L vs.（11.5 ± 5.2） ng/L],the difference was statistically significant （P＜ 0.05）; but there was no significant between two groups in white blood cell count （WBC）,IL-6 （P＞ 0.05）.Severe pneumonia in patients with serum PCT decreased rapidly as the disease was effectively controlled,WBC,CRP and IL-6 had been maintained at a high level.CRP decreased （10.3 ± 7.8）％,IL-6 decreased （12.4 ± 6.9）％,PCT decreased （43.5 ± 12.3）％,the difference was statistically significant （P＜ 0.05）.Conclusion Compared with the traditional inflammatory indexes WBC,CRP and IL-6,PCT can assist in the diagnosis of infection,and the rate of change has certain clinical value in judging the prognosis in patients with severe pneumonia.