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目的探讨社区获得性肺炎(CAP)患者血清降钙素原(PCT)和超敏C反应蛋白(hs-CRP)及N端B型脑钠肽前体(NT-pro BNP)水平的表达意义。方法选取2013年1月—2014年1月四川省广安市人民医院呼吸内科收治的60例CAP患者,按其X线表现分为大叶性肺炎组30例、小叶性肺炎组22例及间质性肺炎组8例,另选取同期体检健康者10例作为对照组。所有受试者抽取空腹静脉血2ml,测定白细胞计数(WBC)及中性粒细胞分数(N%),并检测血清PCT、hs-CRP及NT-pro BNP水平。结果 3组CAP患者血清PCT、hs-CRP、NT-pro BNP水平均高于对照组(P<0.05);大叶性肺炎组及间质性肺炎组PCT水平高于小叶性肺炎组(P<0.05);大叶性肺炎组hs-CRP水平高于小叶性肺炎组和间质性肺炎组(P<0.05);小叶性肺炎组患者NT-pro BNP水平高于大叶性肺炎组及间质性肺炎组(P<0.05);大叶性肺炎组和间质性肺炎组PCT阳性率、hs-CRP升高率均高于小叶性肺炎组(P<0.01)。大叶性肺炎组PCT阳性率与间质性肺炎组比较,差异无统计学意义(P>0.05),但两组均高于小叶性肺炎组,差异有统计学意义(P<0.05);大叶性肺炎组和间质性肺炎hs-CRP升高率均高于小叶性肺炎组,差异有统计学意义(P<0.05),大叶性肺炎组hs-CRP升高率与间质性肺炎组比较,差异无统计学意义(P>0.05)。3组WBC、N%升高率比较,差异无统计学意义(P>0.05)。结论在CAP患者中PCT、hs-CRP、NT-pro BNP水平均有变化,但炎性部位不同,上述指标的变化也不尽相同。
Objective To investigate the expression of serum procalcitonin (PCT), hs-CRP and NT-pro BNP in patients with community-acquired pneumonia (CAP). Methods From January 2013 to January 2014, 60 CAP patients admitted to Department of Respiratory Medicine of Guang’an People’s Hospital of Sichuan Province were divided into 30 cases of lobar pneumonia group, 22 cases of lobular pneumonia group and 20 cases of interstitial pneumonitis Pneumonia group of 8 patients, the other health examination in the same period selected 10 cases as a control group. All subjects took fasting venous blood (2ml), determined white blood cell count (WBC) and neutrophil fraction (N%), and detected serum PCT, hs-CRP and NT-pro BNP levels. Results The levels of PCT, hs-CRP and NT-pro BNP in CAP patients were significantly higher than those in control group (P <0.05). PCT levels in lobar pneumonia group and interstitial pneumonia group were higher than those in lobular pneumonia group (P < 0.05). The level of hs-CRP in lobar pneumonia group was higher than that in lobular pneumonia group and interstitial pneumonia group (P <0.05). NT-pro BNP level in patients with lobular pneumonia group was higher than that in lobar pneumonia group and stroma (P <0.05). The positive rates of PCT and hs-CRP in lobar pneumonia group and interstitial pneumonia group were higher than those in lobular pneumonia group (P <0.01). There was no significant difference between PCT group and interstitial pneumonia group (P> 0.05), but both groups were higher than lobular pneumonia group (P <0.05). Large The incidence of hs-CRP in patients with leaf pneumonia and interstitial pneumonia were higher than those in lobular pneumonia group (P <0.05). The incidence of hs-CRP in patients with lobar pneumonia was significantly higher than that in interstitial pneumonia There was no significant difference between the two groups (P> 0.05). There was no significant difference in WBC, N% rise rate between the three groups (P> 0.05). Conclusions The levels of PCT, hs-CRP and NT-pro BNP in patients with CAP have changed, but the changes of the above indexes are different with different inflammatory sites.