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目的研究通过测定入院时C-反应蛋白(CRP)水平和CRP速度来鉴别急性失代偿性心力衰竭(ADHF)与肺炎的功效。方法回顾性研究三级医院两年的ADHF与肺炎患者的病例资料。住院时已经用抗生素治疗的患者除外。CRP作为诊断标志物的有效性通过ROC来评估。结果 72例ADHF和50例肺炎患者被纳入研究。ADHF患者入院时平均CRP水平为(13.5±13.5)mg/L,而肺炎患者为(127±84)mg/L(P<0.001)。CRP增加大于等于0.56 mg/(L·h)时诊断肺炎。入院时CRP水平和CRP升高作为区别肺炎与ADHF的标记物时的敏感度是0.96,特异性为0.972。结论本研究强调生物标志物的动态特性,证实了急性期反复测量CRP的有效性,它将为临床医生提供有价值的工具来建立正确的诊断及减少不必要的抗生素使用。
Objective To identify the efficacy of acute decompensated heart failure (ADHF) and pneumonia by measuring C-reactive protein (CRP) levels and CRP velocity at admission. Methods A retrospective study of two years of tertiary hospital data on patients with ADHF and pneumonia. Patients who have been treated with antibiotics on admission are excluded. The effectiveness of CRP as a diagnostic marker is assessed by ROC. Results 72 cases of ADHF and 50 cases of pneumonia were included in the study. The average CRP level at admission was (13.5 ± 13.5) mg / L in ADHF patients and (127 ± 84) mg / L in pneumonia patients (P <0.001). Pneumonia was diagnosed when CRP increased 0.56 mg / (L · h) or more. CRP levels and elevated CRP at admission were 0.96 for a sensitivity of 0.972 as a marker for distinguishing between pneumonia and ADHF. Conclusions This study emphasizes the dynamic nature of biomarkers and confirms the validity of CRP measured repeatedly in acute phase and will provide clinicians with valuable tools to establish correct diagnosis and reduce unnecessary use of antibiotics.