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目的研究降钙素原(PCT)对社区获得性肺炎(CAP)和肺结核(PTB)中的鉴别诊断,以及对CAP的预后判断中的价值。方法对2012年4月-2013年8月住院治疗的56例CAP和58例PTB患者临床资料进行分析,CAP组患者根据治疗效果分为有效组(36例)和无效组(20例),分别比较PCT的水平差异,并研究PCT与CURB-65评分的相关性。结果 CAP组患者的C-反应蛋白(CRP)及PCT水平分别为(58.09±41.21)mg/L及(0.33±1.03)ng/ml,高于PTB组患者(21.02±24.57)mg/L及(0.05±0.21)ng/ml,差异有统计学意义(P<0.05);CAP治疗有效组患者的PCT水平为(0.21±1.01)ng/ml,低于无效组(1.25±2.21)ng/ml,差异有统计学意义(P<0.05);CAP组患者CURB-65评分与PCT水平呈现正相关的关系(r=0.404,P=0.002)。结论通过监测PCT水平一定程度上能够辅助鉴别诊断CAP和PTB,且PCT水平与CAP疾病严重程度呈正相关,对CAP患者的预后有一定的预测价值。
Objective To investigate the value of procalcitonin (PCT) in the differential diagnosis of community acquired pneumonia (CAP) and pulmonary tuberculosis (PTB), as well as the prognostic value of CAP. Methods The clinical data of 56 patients with CAP and 58 patients with PTB treated in hospital from April 2012 to August 2013 were analyzed. Patients in CAP group were divided into effective group (36 cases) and ineffective group (20 cases) according to the therapeutic effect respectively PCT differences in levels were compared and the correlation between PCT and CURB-65 scores was studied. Results The serum levels of CRP and PCT in CAP group were (58.09 ± 41.21) mg / L and (0.33 ± 1.03) ng / ml, respectively, higher than those in PTB group (21.02 ± 24.57) mg / L and 0.05 ± 0.21) ng / ml, the difference was statistically significant (P <0.05). The PCT level in CAP-treated group was (0.21 ± 1.01) ng / ml which was lower than that in ineffective group (1.25 ± 2.21) ng / (P <0.05). There was a positive correlation between CURB-65 score and PCT level in CAP group (r = 0.404, P = 0.002). Conclusions The level of PCT can be used to diagnose CAP and PTB to some extent by monitoring the level of PCT. The PCT level is positively correlated with the severity of CAP disease and has a certain predictive value for the prognosis of patients with CAP.