摘要
目的:探讨血清降钙素原(PCT)和淀粉样蛋白A(SAA)测定联合痰细菌培养诊断细菌性肺炎的临床意义。方法:收集2022年1月至2023年6月我院收治的120例肺部感染患者的临床资料实施回顾性分析。依据患者的最终诊断结果实施分组,其中病毒性肺炎组60例,细菌性肺炎组60例,对比两组患者的血清学炎性指标检查结果[PCT,SAA,C反应蛋白(CRP)]、痰标本细菌培养结果,分析鉴别诊断细菌性肺炎与病毒性肺炎的独立影响因素,以及各因素在细菌性肺炎诊断中的预测价值。结果:两组患者的血清CRP水平比较,差异无统计学意义(P>0.05);细菌性肺炎组患者的血清PCT、SAA水平均高于病毒性肺炎组(P<0.05)。多因素Logistic分析结果显示,血清PCT、SAA水平,以及痰标本细菌培养结果是鉴别诊断细菌性肺炎与病毒性肺炎的独立影响因素(P<0.05)。利用PCT、SAA、痰标本细菌培养结果以及Logistic回归模型的P值对细菌性肺炎进行预测,约登指数分别为41.67%、35.00%、78.33%、81.67%。结论:血清PCT和SAA水平对细菌性肺炎与病毒性肺炎具有较为良好的鉴别诊断意义,PCT和SAA测定联合痰细菌培养可以进一步提升对细菌性肺炎的预测诊断价值。
Objective:To explore the clinical significance of serum procalcitonin(PCT)and amyloid A(SAA)determination combined with sputum bacterial culture in the diagnosis of bacterial pneumonia.Methods:The clinical data of 120 patients with pulmonary infection admitted to our hospital from January 2022 to June 2023 were retrospectively analyzed.The patients were grouped according to the final diagnosis results,including 60 cases in the viral pneumonia group and 60 cases in the bacterial pneumonia group.The results of serological inflammatory indicators[PCT,SAA,C-reactive protein(CRP)]and bacterial culture results of sputum specimen of the two groups of patients were compared.The independent influencing factors for the differential diagnosis of bacterial pneumonia and viral pneu-monia,and the predictive value of each factor in the diagnosis of bacterial pneumonia were analyzed.Results:There was no statistical difference in serum CRP levels between the two groups of patients(P>0.05).The levels of serum PCT and SAA of patients in the bacterial pneumonia group were higher than those in the viral pneumonia group(P<0.05).Multivariate Logistic analysis showed that serum PCT,SAA levels and bacterial culture results of sputum specimen were independent influencing factors in the differential diagnosis of bacterial pneumonia and viral pneumonia(P<0.05).PCT,SAA,bacterial culture results of sputum specimen and P value of Logistic regression model were used to predict bacterial pneumonia,and the Yoden index was 41.67%,35.00%,78.33%and 81.67%,respectively.Conclusion:Serum PCT and SAA levels have a relatively good significance in the differential diagnosis of bacterial pneumonia and viral pneumonia,and the combination of PCT and SAA determination and sputum bacterial culture can further improve the prediction and diagnosis value for bacterial pneumonia.
作者
刘爱波
张玉侠
LIU Aibo;ZHANG Yuxia(Department of Laboratory Medicine,the Third Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221003,China)
出处
《中国医药导刊》
2024年第3期275-279,共5页
Chinese Journal of Medicinal Guide
