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降钙素原检测诊断肺结核合并肺部细菌感染的价值(1)
http://www.100md.com 2020年1月15日 《医学信息》 20202
     摘要:目的 分析肺結核合并肺部细菌感染患者检测降钙素原(PCT)在临床诊断中的重要价值。方法 回顾分析2018年4月~2019年4月在我院诊治的112例肺结核患者临床资料,将未合并肺部感染69例设为未合并组,将合并肺部感染43例设为合并组。合并组给予抗菌治疗,依据抗菌效果分为控制组和未控制组,比较合并组与未合并组、控制组和未控制组治疗前后血清PCT水平。结果 合并组血清PCT高于未合并组,差异有统计学意义(P<0.05);控制组和未控制组治疗前血清PCT比较,差异无统计学意义(P>0.05);治疗后控制组血清PCT低于治疗前,且控制组低于未控制组,差异有统计学意义(P<0.05);合并组43例患者,肺部细菌感染的ROC曲线下面积为0.941,95%CI:0.896~0.983,临界值为0.674 μg/L,PCT检测敏感度为86.04%(37/43),特异度94.87%(37/39)。结论 肺结核合并肺部细菌感染患者血清PCT监测,有助于判断患者是否合并肺部感染及抗菌药物治疗效果,为临床诊断和指导抗菌药提供一定的参考。

    关键词:降钙素原;肺结核;肺部细菌感染;诊断价值

    中图分类号:R521 文献标识码:A DOI:10.3969/j.issn.1006-1959.2020.02.058

    文章编号:1006-1959(2020)02-0179-02

    Abstract:Objective To analyze the important value of detecting procalcitonin (PCT) in clinical diagnosis of patients with pulmonary tuberculosis complicated by pulmonary bacterial infection. Methods The clinical data of 112 patients with tuberculosis diagnosed and treated in our hospital from April 2018 to April 2019 were retrospectively analyzed. 69 patients with uncomplicated pulmonary infection were designated as uncombined group, and 43 patients with combined pulmonary infection were designated as combined group. The combined group was given antibacterial treatment, which was divided into the control group and the uncontrolled group according to the antibacterial effect. The serum PCT levels before and after the treatment was compared between the combined group and the uncombined group, the control group and the uncontrolled group.Results The serum PCT in the combined group was higher than that in the non-combined group,the difference was statistically significant(P<0.05).There was no significant difference in serum PCT between the control group and the uncontrolled group before treatment(P>0.05);After treatment, the serum PCT in the control group was lower than before the treatment,and the control group was lower than the non-control group,the difference was statistically significant(P<0.05).The area under the ROC curve of lung infection of 43 patients in the combined group was 0.941, 95%CI: 0.896~0.983, and the cutoff was 0.674 μg/L, PCT detection sensitivity was 86.04%(37/43), specificity was 94.87%(37/39).Conclusion The monitoring of serum PCT in patients with pulmonary tuberculosis complicated by pulmonary bacterial infection can help to determine whether it is associated with pulmonary infection and the effect of antibacterial treatment., http://www.100md.com(宋国锋)
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