郑振羽，佘　晖，陈方榕

厦门大学附属福州第二医院呼吸内科，福建福州　350007

血清PCT及CRP在重症肺炎中的临床价值分析

郑振羽，佘晖，陈方榕

厦门大学附属福州第二医院呼吸内科，福建福州350007

目的 分析重症肺炎血清PCT、CRP、WBC、变化特点，评价PCT、CRP应用价值。方法 方便选取2012年1月—2015年12月该院呼吸重症监护病房收治的肺炎作为研究对象，纳入重症肺炎患者80例，纳入重症组，按照年龄（± 2）、性别一对一选择同期收治的普通肺炎患者纳入普通组，分别在治疗前、入院48 h、72 h、感染控制时，抽取外周静脉血检测血常规，并检测CRP、PCT水平。结果 重症组PCT、CRP高于普通组，差异具有统计学意义（P＜0.05）；PCT敏感度93%、特异度88%、符合率90%，CRP则为89%、75%、82%，PCT敏感度、特异度与符合率高于WBC，PCT特异度高于CRP，差异具有统计学意义（P＜0.05）；48 h后，PCT低于治疗前，72 h后、感染控制时PCT、CRP、WBC低于治疗前与48 h后，感染控制时低于72 h后，差异具有统计学意义（P＜0.05）；入院时，PCT、CRP、WBC水平与PSI、APACHEⅡ均具有相关性，其中PCT相关性系数高于其他指标。结论血清PCT、CRP可作为重症肺炎鉴别诊断标准，评估治疗效果，PCT对治疗更敏感变化速度快，CRP可反映一个阶段内疾病与治疗关系，若在72h内开始下降反映治疗起效。

重症肺炎；炎症；PCT；CRP

Department of Internal Medicine，The Second Affiliated Hospital of Xiamen University，Fuzhou，Fujian Province，350007 China［Abstract］Objective To analysis of severe pneumonia serum PCT，CRP，WBC，change characteristics，evaluation of PCT，CRP value.Methods Convenient selection in January 2012 to December 2015，in RICU pneumonia as the object of study into 80 cases of patients with severe pneumonia，included in the severe group，according to age（±2），the sex of choice during this period were common pneumonia patients into normal group，respectively before treatment，admission for 48 h，72 h，infection control，collected peripheral venous blood routine detection，and detection of CRP，PCT levels.Results Severe group PCT CRP more than The normal group，the difference is statistically significant（P＜0.05）；PCT sensitivity of 93%，a specificity of 88%，in line with the rate of 90%，CRP was 89%，75%，82%，PCT sensitivity，specificity and coincidence rate higher than that of WBC，PCT specificity than CRP，the difference is statistically significant（P＜0.05）；48 PCT lower after treatment than that before，after 72 h，infection control PCT，CRP，WBC was lower than before treatment and 48 h，infection control less than 72 h，the difference is statistically significant（P＜0.05）；at the time of admission，PCT，CRP，WBC levels and psi，APACHE II have correlation，which PCT correlation coefficient higher than other indicators.Conclusion Serum PCT.CRP can be as severe pneumonia diagnosis criteria to evaluate the effects of the treatment，PCT is more sensitive to treatment changes fast.CRP can reflect a stage of disease and treatment，if within 72 h began to decline to reflect the therapeutic effect.

［Key words］Severe pneumonia；Inflammation；PCT；CRP

重症肺炎肺炎是一种起源于肺部但不局限于肺部的重度感染性疾病，是最常见，也是致人类死亡最常见感染性疾病，仅在我国每年便发生小儿重症肺炎肺炎60万～100万例，其中死亡30万例，我国每年重症社区获得性肺炎 （severe community-acquired pneumonia，CAP）死亡率高达12.5/万，重症监护室内医院获得性肺炎（severe hospital acquired pneumonia，HAP）发生率高达12.0%～25.7%，重症肺炎成为最常见的医院感染，没有之一［1-2］。……