降钙素原、D-二聚体、血沉、前白蛋白在成人重症社区获得性肺炎中的预测价值

Predictive Value of Procalcitonin, D-Dimer, Erythrocyte Sedimentation Rate and Prealbumin in Severe Community-Acquired Pneumonia in Adults

摘要: 目的：探讨分析血清降钙素原(PCT)、D-二聚体(D-Dimer)、血沉(ESR)、前白蛋白(PA)计数检测在成人重症社区获得性肺炎中的预测价值。方法：选取75例从2015年1月至2021年12月治疗的成人重症社区获得性肺炎患者作为观察组，另选取90例同期成人轻型社区获得性肺炎患者作为对照组，收集两组人群入院前后24 h的血清PCT、D-Dimer、ESR、PA计数，比较观察组与对照组之间的差异，并比较四项指标的灵敏度和特异度。结果：观察组PCT、D-Dimer、ESR计数均明显高于对照组，观察组PA计数明显低于对照组，差异有统计学意义(P < 0.05)，PA诊断灵敏性(100%)高于ESR (95.2%)及D-Dimer (90.7%)，PCT诊断灵敏性最低(45.5%)；PCT的诊断特异度最高，为95.3%，D-Dimer为50.6%，ESR为48.6%，PA最低，为12.9%。结论：本研究表明，血清PCT、D-Dimer、ESR、PA的联合检测对成人重症社区获得性肺炎的诊断具有一定的指导价值，值得临床推广应用。

Abstract: Objective: To investigate the predictive value of serum procalcitonin (PCT), D-Dimer (D-dimer), erythrocyte sedimentation rate (ESR) and prealbumin (PA) count in adults with severe communi-ty-acquired pneumonia. Methods: Seventy-five adult patients with severe community-acquired pneumonia treated from January 2015 to December 2021 were selected as the observation group, and 90 adult patients with mild community-acquired pneumonia during the same period were se-lected as the control group. Serum PCT, D-Dimer, ESR, and PA counts of the two groups were col-lected 24 hours before and after admission. The differences between the observation group and the control group were compared, and the sensitivity and specificity of the four measures were com-pared. Results: PCT, D-Dimer and ESR counts in the observation group were significantly higher than those in the control group, while PA counts in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). The diagnostic sensitivity of PA (100%) was higher than that of ESR (95.2%) and D-Dimer (90.7%). The diagnostic sensitivity of PCT was the lowest (45.5%). The diagnostic specificity of PCT was the highest (95.3%), D-Dimer was 50.6%, ESR was 48.6%, and PA was the lowest (12.9%). Conclusion: This study shows that the com-bined detection of serum PCT, D-Dimer, ESR and PA has certain guiding value in the diagnosis of adult severe community-acquired pneumonia, and is worthy of clinical application.