李辉++李素芬

【摘要】目的探讨联合检测血清降钙素原（PCT）和血清前白蛋白（PA）在呼吸道感染性疾病中的诊断价值。 方法收集2012年8月至2014年12月在呼吸科就诊治疗的呼吸道感染患者100例纳入观察组，另外选择同期在体检中心接受体格检查的正常人员100例作为对照组，测定两组对象的PCT和PA含量，比较两组的PCT和PA阳性情况，观察治疗前后PCT和PA含量变化情况。结果观察组患者PCT含量明显高于对照组，PA明显低于对照组（P<0.01）， 观察组PCT和PA检查阳性率均明显高于对照组（P<0.01），治疗后患者PCT含量较治疗前明显降低，PA含量较治疗前明显升高（P<0.01）。结论PCT和PA能较敏感地反映人呼吸道是否存在感染，两者联合检测能较快地对呼吸道感染进行鉴别诊断，利于指导临床用药，减少抗菌药的不合理使用率。

【关键词】血清降钙素原；血清前白蛋白；呼吸道感染性疾病

中图分类号：R446.6 文献标识码：ADOI：10.3969/j.issn.10031383.2015.06.019

Application of detection of serum procalcitonin and serum

prealbumin in respiratory tract infections

LI Hui，LI Sufen

（Department of Nuclear Medicine，Liuzhou Municipal Liutie Central Hospital，Liuzhou 545007，Guangxi，China）

【Abstract】ObjectiveTo investigate diagnostic value of serum procalcitonin（PCT） and serum prealbumin（PA） in respiratory tract infections.Methods100 patients with respiratory tract bacterial infections who were treated in respiratory department from August，2012 to December，2014 were included into observation group，and 100 persons who received physical examination at the same period in examination center were selected as control group.Then，contents of serum PCT and PA of the two groups were tested，positive situation of PCT and PA were compared，changes of PCT and PA contents before and after treatment were observed.Results The PCT content of the observation group were significantly higher than that of the control group，but PA was significantly lower than that in the control group（P<0.01）.The positive rate of PCT and PA in the observation group were significantly higher than those of the control group（P<0.01）.The content of PCT after treatment was significantly lower than that before treatment，but the PA content was significantly higher than that before treatment（P<0.01）.Conclusion PCT and PA are reliable indicators for diagnosis of respiratory tract infections，combined detection of them can quickly diagnose respiratory diseases，guide rational clinical therapy，and reduce the unreasonable use rate of antibiotics.

【Key words】serum PCT；serum PA；respiratory tract infections

呼吸道感染性疾病根据发生部位分为上呼吸道感染和下呼吸道感染，前者大多数是由病毒感染所致，病毒感染后通常会继发细菌感染。后者多由支原体、衣原体、细菌、病毒和微生物感染所致。呼吸道既是空气所经过的管道，也是防御、清除异物、调节空气温度和湿度的屏障，因此治疗其感染应尽早明确致病原，以选择有效治疗方案。病毒性感染时白细胞计数一般正常或偏低，而细菌感染则白细胞计数增加，且伴中性粒细胞增多现象。然而呼吸道细菌感染初期和部分严重细菌感染患者白细胞并未明显升高，这给细菌感染和病毒感染的鉴别诊断增加了难度，也易导致用药不合理[1]。故临床上需针对感染进行早期诊断。近年来，随着实验室检查手段的进步，临床上对感染性疾病的早期鉴别诊断出现了一些新指标，如血清降钙素原（PCT）和血清前白蛋白（PA）可为早期感染的快速诊断提供依据。……