降钙素原检测在重症肺炎治疗中的应用价值

林大勇

[摘要] 目的 探讨重症肺炎患者经降钙素原（PCT）治疗的临床效果。 方法 选择2013年1月～2015年6月我院收治的重症肺炎患者，随机抽取64例作为观察组，后随机选取同期我院收治的轻度肺炎患者64例作为对照组，均采集静脉血进行血常规检验，比较两组患者的PCT、白细胞计数（WBC）、C反应蛋白（CRP）和体温等指标。根据PCT水平的差异，将观察组64例分为A组（3例，PCT≥0.5 μg/L）、B组（5例，0.5 μg/L10 μg/L），对其死亡率、呼吸机应用以及抗生素治疗时间等指标进行评价。 结果 观察组患者的PCT和CRP水平均显著高于对照组，差异有统计学意义（P<0.05），WBC水平和体温比较差异无统计学意义（P>0.05）。重症肺炎患者的预后指标与PCT水平有密切联系，且呈正相关，PCT水平越高，死亡率、呼吸机使用率、抗生素使用时间均会上升（P<0.05）。 结论 重症肺炎患者经PCT治疗具有显著意义，可以为该病的临床诊断提供科学的参考。

[关键词] 重症肺炎；降钙素原；临床效果

[中图分类号] R563.1 [文献标识码] A [文章编号] 1674-4721（2016）02（c）-0037-03

[Abstract] Objective To explore the clinical effects of procalcitonin in treating severe pneumonia. Methods 64 severe pneumonia patients from January 2013 to June 2015 of our hospital were randomly selected as study object.64 mild pneumonia at the same term were randomly selected as control group.Blood routine examination were conducted by collecting venous blood.The index of PCT，WBC，CRP and temperature were evaluated.According to the difference of PCT level，64 patients in observation group were divided into group A （n=3，PCT≥0.5 μg/L），group B （n=5，0.5 μg/L10 μg/L）.The index of death rate，ventilator using rate and antibiotic treatment time were evaluated. Results The level of PCT and CRP in observation group were obvious higher than those in control group，and the differences were significant （P<0.05），while the level of WBC and temperature between groups had no statistical significance （P>0.05）.The prognostic indicator of severe pneumonia patients had positive relation with the level of PCT，and with the high level of PCT，the high death rate，ventilator using rate and antibiotic treatment time （P<0.05）. Conclusion Procalcitonin in treating severe pneumonia has great meaning.It can provide scientific reference basis for clinical diagnosis of severe pneumonia.

[Key words] Severe pneumonia；Procalcitonin；Clinical effect

肺炎是一种感染性疾病，会对人类的身体健康产生严重威胁。如果肺炎病情持续发展，形成重症肺炎，还会危及患者的生命安全，具有较高的病死率[1]。由于重症肺炎的临床特点具有多样化特征，而且病情发展迅速，会对患者身体内各个器官的正常功能造成严重影响。肺炎主要是由细菌性肺炎的毒血症而引发的一种疾病，会引发人体微循环障碍[2-3]。经细菌检验发现，溶血性链球菌和肺炎链球菌是导致肺炎最主要的病原体。感染肺炎后，患者的主要临床表现为血压有所下降、意识不清等。……