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目的分析血清降钙素原(PCT)对老年社区获得性细菌性肺炎的诊断价值及对抗生素药物使用的指导作用。方法将我院确诊为社区获得性肺炎的老年患者100例根据致病菌的不同分为细菌组60例、病毒组20例和支原体组20例,比较三组血清降钙素原、C-反应蛋白和白细胞计数的水平差异。细菌组的60例中30例患者(PCT组)根据血清降钙素原的水平变化来指导抗生素的应用,另外30例患者(常规组)采用常规方法使用抗生素,比较两小组临床治疗效果和炎性指标的变化。结果细菌组患者的血清降钙素原水平[(1.73±0.43)μg/L]明显高于病毒组[(0.12±0.03)μg/L]和支原体组[(0.19±0.05)μg/L](P<0.05);血清降钙素原对老年社区获得性细菌性肺炎的诊断特异性(96.67%)明显优于C-反应蛋白(66.67%)(P<0.05)。细菌组治疗后,PCT组各项指标明显好于常规组,差异有统计学意义(P<0.05)。结论血清降钙素原诊断老年社区获得性细菌性肺炎的特异性较高,对抗生素药物的应用具有指导应用,避免了细菌耐药的发生,建议在临床上广泛使用。
Objective To analyze the diagnostic value of serum procalcitonin (PCT) in senile community-acquired bacterial pneumonia and its guidance on the use of antibiotics. Methods 100 cases of elderly patients diagnosed as community-acquired pneumonia in our hospital were divided into 60 bacterial groups, 20 cases of virus group and 20 cases of mycoplasma group according to different pathogenic bacteria. The serum procalcitonin, C- Differences in protein and white blood cell count levels. Thirty patients in the bacterial group (PCT group) guided the use of antibiotics based on changes in serum procalcitonin levels. Another 30 patients (routine group) received antibiotics in a routine manner and compared the clinical efficacy and inflammation of the two subgroups Changes in sexual indicators. Results The level of serum procalcitonin in the bacterial group was significantly higher than that in the virus group [(0.73 ± 0.43) μg / L and [0.19 ± 0.05) μg / L] P <0.05). The specificity of serum procalcitonin for elderly community-acquired bacterial pneumonia (96.67%) was significantly better than that of C-reactive protein (66.67%) (P <0.05). After treatment with bacterial group, the indexes of PCT group were significantly better than those of conventional group (P <0.05). Conclusions Serum procalcitonin has a high specificity in the diagnosis of community-acquired bacterial pneumonia in the elderly. It has direct application to the application of antibiotics and avoids the occurrence of bacterial resistance. It is suggested that it should be widely used clinically.