1、降鈣素原檢測診斷肺結核合并肺部細菌感染的價值降鈣素原檢測診斷肺結核合并肺部細菌感染的價值1959202102-0179-02Abstract：Objective To analyze the important value of detecting procalcitonin PCT in clinical diagnosis of patients with pulmonary tuberculosis complicated by pulmonary bacterial infection. Methods The clinical data of 112 patients with tu

2、berculosis diagnosed and treated in our hospital from April 2021 to April 2021 were retrospectively analyzed. 69 patients with uncomplicated pulmonary infection were designated as uncombined group， and 43 patients with combined pulmonary infection were designated as combined group. The combined grou

3、p was given antibacterial treatment， which was divided into the control group and the uncontrolled group according to the antibacterial effect. The serum PCT levels before and after the treatment was compared between the combined group and the uncombined group， the control group and the uncontrolled

4、 group.Results The serum PCT in the combined group was higher than that in the non-combined group，the difference was statistically significantP0.05.There was no significant difference in serum PCT between the control group and the uncontrolled group before treatmentP>0.05;After treatment， the ser

5、um PCT in the control group was lower than before the treatment，and the control group was lower than the non-control group，the difference was statistically significantP0.05.The area under the ROC curve of lung infection of 43 patients in the combined group was 0.941， 95%CI： 0.8960.983， and the cutof

6、f was 0.674 g/L， PCT detection sensitivity was 86.04%37/43， specificity was 94.87%37/39.Conclusion The monitoring of serum PCT in patients with pulmonary tuberculosis complicated by pulmonary bacterial infection can help to determine whether it is associated with pulmonary infection and the effect o

7、f antibacterial treatment. 0.05，討論可比。治療后根據抗菌效果分為操縱組21例和未操縱組22例。本討論經過醫院倫理委員會批準，患者自愿參與本討論，并簽署知情同意書。1.2方法1.2.1治療方法 全部患者均接受規律抗結核化療，化療方案2HREZ/4HR，養分狀態較差者給予靜脈養分支持，合并組行痰液及血細菌培育+藥敏試驗，給予廣譜三代頭孢類抗菌藥抗感染治療，細菌培育及藥敏結果反饋后根據藥敏結果給予敏感抗菌藥治療。1.2.2試驗室檢測 儀器：瑞士生產全自動生化分析儀;標本采集：取全部患者晨起空腹靜脈血5 ml，離心10 min，分別血清后送檢。PCT接受半定量的膠體金免

8、疫結合法，嚴格根據PCT定量測定試劑盒說明書進行操作。1.3觀看指標 比較合并組與未合并組血清PCT水平;操縱組和未操縱組治療前后血清PCT水平。肺部感染操縱：抗感染治療7 d后體溫正常，無反復發熱，肺部影像學表現改善或無進展或痰液、血液標本菌培育陰性則為肺部感染操縱;抗感染治療后仍有反復發熱、肺部影像學顯示進展，則為肺部感染未操縱。1.4統計學方法 使用SPSS 24.0統計軟件進行分析，計量資料接受x±s表示，兩組間比較接受t檢驗，計數資料接受n和%表示，兩組間比較接受？字2檢驗，P0.05;治療后操縱組血清PCT低于治療前，且操縱組低于未操縱組P<0.05，說明抗感染治療有效患者治療后PCT水平下降，未掌握組患者PCT水平無明顯改變，進一步提示PCT水平改變在肺結核合并肺部感染治療中可較早預報抗菌藥物治療療效。肺部細菌感染R0C曲線下面積為0.941，95%CI：0.8960.983，臨界值為0.674 g/L，PCT檢測敏感度為86.04%37/43，特異度94.87%37/39，PCT判定肺結核合并肺部感染的最正確臨床臨界參考值為0.674 g/