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目的:探讨肺泡灌洗液降钙素原(PCT)水平检测在卫生保健相关性肺炎(HCAP)中的应用。方法:回顾性分析2013年6月至2015年2月梅州市人民医院收治的68例HCAP患者的临床资料,其中重症肺炎组(26例)、轻症肺炎组(42例),同期68名健康体检者作为对照组;分别在HCAP患者使用抗生素1、4、7 d行支气管镜下肺泡灌洗时取灌洗液行PCT检测,同时行血PCT检测,比较二者数据动态变化。结果:重症肺炎组、轻症肺炎组、对照组血清PCT浓度比较,差异均有统计学意义(P<0.05)。HCAP患者肺泡灌洗液PCT值始终高于血清PCT值(P<0.05)。血清PCT和肺泡灌洗液PCT曲线下面积(AUC)分别为0.757、0.972。结论:与血清PCT检测相比,肺泡灌洗液PCT检测HCAP效能更佳。
Objective: To investigate the application of alveolar lavage fluid procalcitonin (PCT) in the detection of health care related pneumonia (HCAP). Methods: The clinical data of 68 patients with HCAP admitted from June 2013 to February 2015 in Meizhou People’s Hospital were retrospectively analyzed. Among them, severe pneumonia group (26 cases), mild pneumonia group (42 cases) and 68 healthy persons The subjects were used as the control group. The patients undergoing HCAP were given bronchoalveolar lavage bronchoalveolar lavage for 1, 4 and 7 days respectively. The PCT test was performed on the samples while the blood PCT was tested. The dynamic changes of the two data were compared. Results: The serum PCT concentrations in severe pneumonia group, mild pneumonia group and control group were significantly different (P <0.05). The PCT value of alveolar lavage fluid in HCAP patients was always higher than the serum PCT value (P <0.05). The area under the PCT curve (AUC) of serum PCT and BAL was 0.757 and 0.972, respectively. Conclusion: Compared with serum PCT detection, the efficacy of PCT in detecting pulmonary alveolar lavage fluid PCT is better.