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目的探讨血清降钙素原(PCT)对急性左心衰竭并发社区获得性肺炎患者的临床价值。方法从2014年1月-2017年2月到医院就诊的急性左心衰竭的患者中选择106例,其中合并社区获得性肺炎者56例,未合并肺炎者50例,并将其分为研究组和对照组。比较两组患者动态血清PCT、C-反应蛋白(CRP)变化,血清PCT浓度水平与肺炎严重程度、抗菌药物使用时间、住院时间的关系,并将研究组分为细菌感染组29例和非细菌感染组27例,观察两组患者之间血清PCT浓度水平。结果研究组不同时间段血清PCT浓度均比对照组高,差异有统计学意义(P<0.05);以血清PCT>0.05μg/L为阳性标准诊断急性左心衰竭合并社区获得性肺炎的敏感性为91.07%,特异性为88.00%;患者血清PCT浓度水平与患者肺炎严重程度呈正相关,抗菌药物运用时间和住院时间也随血清PCT浓度水平增长而延长;以血清PCT>2.0μg/L为阳性标准诊断急性左心衰竭合并肺部细菌感染的敏感性为75.86%,特异性为70.37%。结论血清PCT在诊断急性左心衰竭合并社区获得性肺炎和判断患者肺炎严重程度中起着重要的作用,并可以估计患者肺部感染的病原体类型。
Objective To investigate the clinical value of serum procalcitonin (PCT) in patients with acute left heart failure complicated with community-acquired pneumonia. Methods From January 2014 to February 2017, 106 patients with acute left heart failure admitted to the hospital were enrolled. Among them, 56 patients with community-acquired pneumonia and 50 patients without pneumonia were divided into study group And control group. The changes of serum PCT, C-reactive protein (CRP), serum PCT concentration and the severity of pneumonia, the duration of antibiotic use and hospital stay were compared between the two groups. The study group was divided into bacterial infection group (n = 29) Infection group, 27 cases were observed serum PCT concentration between the two groups. Results The concentration of serum PCT in the study group was higher than that in the control group at different time points (P <0.05). The sensitivity of serum PCT> 0.05 μg / L was positive in diagnosing community-acquired pneumonia in acute left heart failure And the specificity was 88.00%. The level of serum PCT in patients was positively correlated with the severity of pneumonia in patients, and the duration of antibacterial use and hospital stay were also prolonged with the increase of serum PCT concentration. The serum PCT> 2.0μg / L was positive The standard diagnosis of acute left heart failure with pulmonary bacterial infection was 75.86% with a specificity of 70.37%. Conclusions Serum PCT plays an important role in diagnosing acute left heart failure with community-acquired pneumonia and in judging the severity of pneumonia in patients, and can estimate the type of pathogen in patients with pulmonary infection.