降钙素原与C-反应蛋白对尘肺患者合并肺部感染的诊断价值
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摘要
目的探讨降钙素原(PCT)与C-反应蛋白(CRP)对尘肺患者合并肺部感染的诊断价值。方法回顾性分析2015年10月-2017年10月于医院进行治疗的尘肺患者50例及同期于医院进行体检的健康者30名的资料,根据疾病情况与痰细菌培养结果分为健康者为A组30名,尘肺患者未合并肺部感染的B组27例,尘肺患者合并肺部感染的C组共23例,对患者的血清PCT,血清CRP浓度,第一秒用力呼气容积(FEV1)与第一秒用力呼气量占用力肺活量比值(FEV1/FVC)进行分析。结果三组研究对象的血清PCT与CRP浓度,肺功能指标数据差异均有统计学意义(P<0.05),三组患者的血清PCT与CRP浓度与肺功能指标进行Fisher判别函数计算,交叉验证判别正确率为100.00%,利用血清PCT与CRP浓度对于B组与C组患者的诊断价值进行计算,结果显示,PCT的诊断灵敏度为82.96%,特异度为91.48%,曲线下面积为0.932,CRP的诊断灵敏度为91.30%,特异度为85.19%,曲线下面积为0.921。结论部分尘肺患者合并肺部感染炎症反应程度加大,肺功能指标降低,利用PCT与CRP对尘肺患者是否合并肺部感染具有较高的诊断价值,但需进行更加深入地探讨。
OBJECTIVE To investigate the diagnostic value of procalcitonin(PCT)and C-reactive protein(CRP)in patients with pneumoconiosis complicated with pulmonary infection.METHODS 50 cases of pneumoconiosis infection treated in the hospital from Oct.2015 to Oct.2017 and 30 healthy persons who had physical examination in the hospital during the same period were selected for retrospective analysis.According to the condition of patients and the results of sputum culture,they were divided into three groups.Among them,the healthy group was A group,with a total of 30 cases.Patients with pneumoconiosis but without bacterial colonization in lower respiratory tract was B group,with a total of 27 cases.Patients with pneumoconiosis and lower respiratory tract bacterial colonization were C group,with 23 cases.The serum PCT,serum CRP concentration,forced expiratory volume in the first second(FEV1)and the ratio of forced expiratory volume to forced vital capacity(FEV1/FVC)in the first second were measured and calculated.RESULTS The serum PCT and CRP concentrations and pulmonary function indicators data were significantly different among the three groups of patients(P<0.05).The concentrations of serum PCT and CRP in the three groups and the indicators of lung function were calculated by Fisher discriminant function,and the correct rate of cross validation was 100%.The diagnostic values of B group and C group calculated using the serum PCT and CRP concentrations showed that the PCT diagnostic sensitivity was 82.96%,specificity was 91.48%,the area under the curve was 0.932,whereas the diagnostic sensitivity of CRP was 91.30%,the specificity was 85.19%,the area under the curve was 0.921.CONCLUSIONInflammation increased and lung function indicators decreased in some of pneumoconiosis patients complicated with pulmonary infection.Procalcitonin and C reactive protein have relatively high values in the diagnosis of patients with pneumoconiosis complicated with pulmonary infection,but a more in-depth discussion is required.
OBJECTIVE To investigate the diagnostic value of procalcitonin(PCT)and C-reactive protein(CRP)in patients with pneumoconiosis complicated with pulmonary infection.METHODS 50 cases of pneumoconiosis infection treated in the hospital from Oct.2015 to Oct.2017 and 30 healthy persons who had physical examination in the hospital during the same period were selected for retrospective analysis.According to the condition of patients and the results of sputum culture,they were divided into three groups.Among them,the healthy group was A group,with a total of 30 cases.Patients with pneumoconiosis but without bacterial colonization in lower respiratory tract was B group,with a total of 27 cases.Patients with pneumoconiosis and lower respiratory tract bacterial colonization were C group,with 23 cases.The serum PCT,serum CRP concentration,forced expiratory volume in the first second(FEV1)and the ratio of forced expiratory volume to forced vital capacity(FEV1/FVC)in the first second were measured and calculated.RESULTS The serum PCT and CRP concentrations and pulmonary function indicators data were significantly different among the three groups of patients(P<0.05).The concentrations of serum PCT and CRP in the three groups and the indicators of lung function were calculated by Fisher discriminant function,and the correct rate of cross validation was 100%.The diagnostic values of B group and C group calculated using the serum PCT and CRP concentrations showed that the PCT diagnostic sensitivity was 82.96%,specificity was 91.48%,the area under the curve was 0.932,whereas the diagnostic sensitivity of CRP was 91.30%,the specificity was 85.19%,the area under the curve was 0.921.CONCLUSIONInflammation increased and lung function indicators decreased in some of pneumoconiosis patients complicated with pulmonary infection.Procalcitonin and C reactive protein have relatively high values in the diagnosis of patients with pneumoconiosis complicated with pulmonary infection,but a more in-depth discussion is required.
引文
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[12] Shen CH,Chen HJ,Lin TY,et al.Association between pneumoconiosis and pulmonary emboli A Nationwide Population-Based Study in Taiwan[J].Thromb Haemost,2015,113(5):952-957.
[13] Harrington AD,Tsirka SE,Schoonen MA.Inflammatory stress response in A549cells as a result of exposure to coal:evidence for the role of pyrite in coal workers'pneumoconiosis pathogenesis[J].Chemosphere,2013,93(6):1216-1221.
[14] Zhou Y,Wang H,Xing J,et al.Expression levels of surfactantassociated proteins and inflammation cytokines in serum and bronchoalveolar lavage fluid among coal miners:a case-control study[J].J Occup Environ Med,2014,56(5):484-488.
[2] Cho Y,Choi M,Myong JP,et al.The association between bronchial anthracofibrosis and pneumoconiosis:a retrospective cross-sectional study[J].J Occup Health,2015,57(2):110-117.
[3]黄锦浪,罗永军,黄潘文.稳定期COPD患者下呼吸道细菌定植对免疫功能、气道功能及炎症程度的影响[J].海南医学院学报,2016,22(24):2959-2962.
[4]聂胜利,吴伍林,王蓓蓓,等.降钙素原检测对重症急性胰腺炎并发感染的诊断价值分析[J].中华普外科手术学杂志(电子版),2017,11(2):162-164.
[5]张卫东,冬兰.PCT、CRP在支气管哮喘合并呼吸道感染中的诊断价值[J].检验医学与临床,2017,14(Z1):359-360.
[6]李德鸿.尘肺病诊断标准[C]尘肺病影像诊断新进展研讨会,2011.
[7] Clinical and Laboratory Standards Insitute.Performance standards for antimicrobial susceptibility testing:twenty-fifth informational supplement(M100-S25)[S].Wayne,PA 19087USA,2015.
[8] Aydemir S,Dindar G,Ozdemir MC,et al.A coal worker's pneumoconiosis diagnosed with endosonography[J].Gastrointest Endosc,2015,82(1):178-179.
[9] Liu QH,Zhang J,Lin DJ,et al.Gastropulmonary route of infection and the prevalence of microaspiration in the elderly patients with ventilator-associated pneumonia verified by molecular microbiology-GM-PFGE[J].Cell Biochem Biophys,2015,71(3):1457-1462.
[10] Hoeboer SH,van der Geest PJ,Nieboer D,et al.The diagnostic accuracy of procalcitonin for bacteraemia:a systematic review and meta-analysis[J].Clin Microbiol Infect,2015,21(5):474-481.
[11] Schmidt S,Windgassen M,Nofer JR,et al.Procalcitonin as a postmortem sepsis marker.A comparison of the validity of results obtained from blood serum,aqueous humour and cerebrospinal fluid[J].Int J Legal Med,2015,129(1):117-123.
[12] Shen CH,Chen HJ,Lin TY,et al.Association between pneumoconiosis and pulmonary emboli A Nationwide Population-Based Study in Taiwan[J].Thromb Haemost,2015,113(5):952-957.
[13] Harrington AD,Tsirka SE,Schoonen MA.Inflammatory stress response in A549cells as a result of exposure to coal:evidence for the role of pyrite in coal workers'pneumoconiosis pathogenesis[J].Chemosphere,2013,93(6):1216-1221.
[14] Zhou Y,Wang H,Xing J,et al.Expression levels of surfactantassociated proteins and inflammation cytokines in serum and bronchoalveolar lavage fluid among coal miners:a case-control study[J].J Occup Environ Med,2014,56(5):484-488.