肺部超声联合降钙素原检测对重症肺炎和非重症肺炎鉴别诊断的临床价值

摘要/Abstract

摘要： 目的：探讨肺部超声（lung ultrasonography，LUS）联合降钙素原（procalcitonin，PCT）检测对诊断重症肺炎和非重症肺炎的临床价值。方法：回顾性研究我院2016年1月至2020年12月期间重症医学科（ICU）收治的重症肺炎患者52例（重症肺炎组），以及急诊科收治的非重症肺炎患者97例（非重症肺炎组）的临床资料。对比分析两组患者的LUS特征、血清PCT水平，以及LUS联合PCT检测对鉴别重症肺炎和非重症肺炎的临床价值。结果：149例患者中，血清PCT＞0.5 ng·mL-1患者93例，其中重症肺炎组患者LUS出现B线＞3条、支气管充气征、肺实变、胸膜异常征及胸腔积液的发生率多于非重症肺炎组（P<0.05）。PCT≤0.5 ng·mL-1患者56例，其中重症肺炎组患者LUS出现B线＞3条、胸膜下结节个数＞3个的发生率高于非重症肺炎组（P<0.05）。ROC曲线下面积显示LUS出现B线＞3条联合PCT＞0.5 ng·mL-1诊断重症肺炎的准确率最高，其AUC为0.94（0.900~0.980）；LUS出现B线≤3条联合PCT≤0.5 ng·mL-1诊断非重症肺炎的准确率最高，其AUC为0.840（0.774~0.906）。结论：LUS联合PCT检测可有效鉴别重症肺炎和非重症肺炎患者，对肺炎患者的病情判断及预后评估有一定指导意义。

关键词: font-size:medium, ">肺部超声；降钙素原；重症肺炎；非重症肺炎

Abstract: Objective：To investigate the diagnosis performance of lung ultrasonography(LUS) combined with procalcitonin(PCT) detection for differentiating severe pneumonia and non-severe pneumonia. Methods:The clinical data of 52 cases of severe pneumonia patientsfrom intensive care unit(ICU)(severe pneumonia group) and 97 cases of non-severe pneumonia patients from the emergency department(non-severe pneumonia group) who were admitted in our hospital between January 2016 and December 2020 were retrospectivly studied. The LUS characteristics， serum PCT level of the two groups of patients were compared， and the clinical value of LUS combined with PCT detection for differentiating severe pneumonia and non-severe pneumonia were analyzed. Results:Among the 149 patients， 93 patients with serum PCT＞0.5 ng·mL-1， and more patients in the severe pneumonia group with B-line＞3， bronchial air sign， lung consolidation， pleural abnormality and pleural effusion than those in the non-severe pneumonia group(P<0.05). Among the 56 patients with PCT≤0.5 ng·mL-1，there were more patients in the severe pneumonia group with B-line＞3 and the number of subpleural nodules＞3 than those in the non-severe pneumonia patients(P<0.05). The ROC curve showed the LUS characteristic of B-line＞3 combined with serum PCT＞0.5 ng·mL-1had the highest performance for the diagnosis of severe pneumonia，and the ACU was 0.94(0.900~0.980). The LUS characteristic of B-line ≤3 combined with serum PCT≤0.5 ng·mL-1had the highest performance for the diagnosis of non-severe pneumonia， and the ACU was 0.840(0.774~0.906). Conclusion:LUS combined with PCT detection can effectively differentiate severe pneumonia and non-severe pneumonia patients， which is helpful for the judgment of the condition and prognosis of pneumonia patients.

Key words: font-size:medium, ">Lung ultrasonography, Procalcitonin, Severe pneumonia, Non-severe pneumonia

中图分类号:

童燕燕, 刘巨方, 马静, 丁景秀. 肺部超声联合降钙素原检测对重症肺炎和非重症肺炎鉴别诊断的临床价值[J]. 中国医药导刊, 2022, 24(4): 375-379.

TONG Yanyan, LIU Jufang, MA Jing, DING Jingxiu. The Diagnostic Performance of Lung Ultrasonography Combined with Procalcitonin Detection for Differentiating Severe Pneumonia and Non-severe Pneumonia[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2022, 24(4): 375-379.

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