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[目的]探讨降钙素原(PCT)对老年人呼吸机相关性肺炎(VAP)的早期诊断价值,提高对该病的诊断水平。[方法]对116例机械通气的老年患者按照7d内是否发生VAP分为VAP组(n=64例)和非VAP组(n=52例),测定其血清PCT水平、C反应蛋白(CRP)及白细胞计数(WBC)。[结果]机械通气后VAP组PCT的阳性率显著高于对照组,差异有统计学意义(P﹤0.05);PCT对VAP诊断敏感性为85.9%,特异性为75.0%,阳性预测值为80.9%,阴性预测值为81.3%,均高于CRP和WBC的相应指标。[结论]PCT对VAP有较高的敏感性和特异性,有助于VAP的早期诊断,值得临床推广应用。
[Objective] To investigate the value of procalcitonin (PCT) in early diagnosis of ventilator-associated pneumonia (VAP) in the elderly and to improve the diagnosis of the disease. [Methods] A total of 116 elderly patients with mechanical ventilation were divided into VAP group (n = 64) and non-VAP group (n = 52) according to whether or not VAP occurred within 7 days. The levels of PCT, C-reactive protein And white blood cell count (WBC). [Results] The positive rate of PCT in VAP group after mechanical ventilation was significantly higher than that in control group (P <0.05). The sensitivity of PCT to VAP diagnosis was 85.9%, specificity was 75.0%, and the positive predictive value was 80.9 %, Negative predictive value was 81.3%, higher than the corresponding indicators of CRP and WBC. [Conclusion] PCT has high sensitivity and specificity to VAP, which is helpful for the early diagnosis of VAP. It deserves clinical application.