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目的探讨C反应蛋白(CRP)对社区获得性肺炎(CAP)的诊断价值。方法对笔者所在医院发热门诊2011年2月—2012年1月接诊的患者进行随机抽样,对抽样获得的611例患者进行回顾性分析。CRP采用QuikRead CRP快速分析仪检测。结果 611例患者中CRP增高394例(占64.5%),其中肺炎患者占16.50%(65/394),而在CRP正常的217例患者中,肺炎占4.15%(9/217),前者明显高于后者(P<0.05)。当CRP值>30 mg·L-1时,约有1/5的患者诊断为肺炎,CRP值>50 mg·L-1时,约有1/4的患者诊断为肺炎。CRP值增高对肺炎诊断的敏感性为87.84%,阳性预测值是16.50%,阴性预测值是95.85%。结论在发热门诊,CRP水平与CAP的诊断有一定的相关性,而且阴性预测值较高。
Objective To investigate the diagnostic value of C-reactive protein (CRP) in community-acquired pneumonia (CAP). Methods A randomized sampling was performed on patients with fever clinic in our hospital from February 2011 to January 2012, and a total of 611 patients sampled from the sample were retrospectively analyzed. CRP was tested using a QuikRead CRP rapid analyzer. Results Among 611 patients, the CRP increased by 394 (64.5%), of which pneumonia accounted for 16.50% (65/394), while in 217 patients with normal CRP, pneumonia accounted for 4.15% (9/217), the former was significantly higher In the latter (P <0.05). About one-fifth of patients diagnosed as pneumonia at CRP> 30 mg · L-1 and pneumonia at about one-fourth of patients with CRP> 50 mg · L-1. The sensitivity of diagnosis of pneumonia was 87.84%, the positive predictive value was 16.50%, and the negative predictive value was 95.85%. Conclusion In fever clinics, the level of CRP is associated with the diagnosis of CAP, and the negative predictive value is high.