罗世深

[摘要]目的探讨降钙素原检测在老年细菌性肺炎诊断中的意义。方法选取2018年8月至2021年2月广东省云浮市中医院收治的145例老年肺炎患者，根据患者感染类型分为细菌性肺炎组（ n=80）和真菌性肺炎组（ n=65）。检测两组患者外周血降钙素原、C 反应蛋白、白细胞水平，并比较其敏感度、特异性、准确度等差异。结果细菌性肺炎组患者降钙素原、白细胞及 C 反应蛋白水平均高于真菌性肺炎组，细菌性肺炎组 C 反应蛋白、白细胞检测阳性率高于真菌性肺炎组，降钙素原检测敏感度、特异性、准确度均高于 C 反应蛋白检测和白细胞检测，差异有统计学意义（ P <0.05）。结论老年细菌性肺炎诊断应用降钙素原检测诊断价值较高，可明显提升敏感度、特异性、准确度，能为患者后续的诊疗提供一定依据。

[关键词]老年细菌性肺炎;降钙素原;诊断;特异性;敏感度

[中图分类号] R563.1  [文献标识码] A   [文章编号]2095-0616（2021）23-0139-04

Clinical value of procalcitonin detection in the diagnosis of bacterial pneumonia in the elderly

LUO  Shishen

Clinical Laboratory， Yunfu Hospital of Traditional Chinese Medicine in Guangdong Province， Guangdong， Yunfu 527300， China

[Abstract] Objective To explore the significance of procalcitonin （PCT） detection in the diagnosis of bacterial pneumonia （BP） in the elderly. Methods A total of 145 elderly patients with pneumonia admitted to Yunfu Hospital of Traditional Chinese Medicine in Guangdong Province from August 2018 to February 2021 were divided into the BP group （n=80） and the fungal pneumonia （FP） group （n=65） according to their infection types. The levels of PCT， C-reactive protein （CRP） and leukocytes in peripheral blood of the two groups were detected， and the differences in sensitivity， specificity and accuracy were compared between the two groups. Results The levels of PCT， leucocytes and CRP in the BP group were higher than those in the FP group. The positive rate of CRP and leucocyte detection in the BP group was higher than that in the FP group. The sensitivity， specificity and accuracy of PCT detection were higher than those of CRP detection and leucocyte detection， with statistically significant differences （P <0.05）. Conclusion PCT detection is of high value in the diagnosis of BP in the elderly， which can obviously improve the sensitivity， specificity and accuracy， and can provide a certain basis for the follow-up diagnosis and treatment of patients.

[Key words] Bacterial pneumonia in the elderly; Procalcitonin; Diagnosis; Specificity; Sensitivity

老年细菌性肺炎症状多不典型，起病较为隐匿，老年患者年龄较高，往往合并多种慢性疾病，机体免疫能力低下，营养状况不佳，给疾病的早期诊断带来一定困难，通过临床检查、影像学检查等在疾病早期往往无法取得满意的诊断效果，易出现误诊、漏诊等情况[1]。降鈣素原是系统性炎症生物标志物，与其他标志物相比有变化快的特点，在血清中能够在4 h 内被发现，12～48 h 到达峰值，在多种疾病的治疗和预后诊断中均得到广泛应用。血清降钙素原检测的临床应用包括多器官功能衰竭、败血症的评估和预测、系统性细菌感染的早期诊断等[2-3]。但针对局部感染细菌降钙素原水平的变化情况相关研究较少。基于以上背景，本研究选取2018年8月至2021年2月于广东省云浮市中医院（我院）接受治疗的145例老年肺炎患者进行分析，旨在探讨降钙素原检测在老年细菌性肺炎诊断中应用效果，现报道如下。……