本文選題：和肽素　切入點：社區(qū)獲得性肺炎　出處：《大連醫(yī)科大學》2013年碩士論文

【摘要】：目的：探討和肽素（copeptin，CPP）對社區(qū)獲得性肺炎(community acquiredpneumonia，CAP)診斷的臨床價值及病情嚴重程度的評估。 方法：本實驗選取CAP患者55例，以結締組織病相關間質性肺疾�。╟onnectivetissue disease complicated with interstitial lung disease，CTD-ILD）患者20例、健康成人15例為對照。根據(jù)PSI評分，CAP分為低危組（0-90分）30例、中危組（91-130分）11例、高危組（130分）14例；根據(jù)CURB-65評分，分為低危組（O-1分或者無毒血癥）41例、中危組（2分，合并毒血癥）6例、高危組（3-5分，，合并嚴重毒血癥或者感染性休克）8例；根據(jù)ATS成人CAP重癥肺炎標準分為重癥肺炎組（15例）和非重癥肺炎組（40例）。采用ELISA法定量檢測血清CPP水平，自動生化儀測定血清C反應蛋白（c-reactive protein，CRP）水平，雙抗體夾心免疫發(fā)光法測定血清降鈣素原（procalcitonin，PCT）水平。采用SPSS17.0統(tǒng)計軟件分析，P0.05為差異有統(tǒng)計學意義。 結果： 1.CAP組及痰菌陽性CAP組血清CPP、CRP、PCT水平均明顯高于健康對照組，差異有統(tǒng)計學意義（P0.05）；CAP組及痰菌陽性CAP組與CTD-ILD組比較，CPP、PCT均明顯增高，差異有統(tǒng)計學意義（P0.05）。 2.PSI及CURB-65分級低危、中危、高危三組各生物標志物水平比較，血清CPP水平高危組均高于低危組及中危組，差異有統(tǒng)計學意義（P0.05）；血清PCT水平高危組高于中危組，差異有統(tǒng)計學意義（P0.05）；血清CRP水平在PSI分級的中危組高于低危組，差異有統(tǒng)計學意義（P0.05）。ATS重癥肺炎組血清CPP水平明顯高于非重癥肺炎組，差異有統(tǒng)計學意義（P0.05），CRP及PCT在兩組間比較差異均無統(tǒng)計學意義（P0.05）。 3.CAP組各生物學標志物水平與PSI、CURB-65評分的相關性分析，CPP水平與PSI評分、CURB-65評分均存在正相關，差異有統(tǒng)計學意義（P0.05）；CRP、PCT水平與PSI評分、CURB-65評分均無相關性，差異無統(tǒng)計學意義（P0.05）。 結論： 1.血清CPP水平對CAP的診斷具有一定的臨床價值。 2.血清CPP水平隨著肺炎程度的加重而明顯增加，其水平能夠反映CAP患者的病情嚴重程度。
[Abstract]:Objective: To evaluate the clinical value and severity of copeptin (CPP) in the diagnosis of community acquired pneumonia (community acquiredpneumonia (CAP)).
Methods: This study selected 55 cases of CAP patients with connective tissue disease related interstitial lung disease (connectivetissue disease complicated with interstitial lung disease, CTD-ILD) in 20 patients and 15 healthy adults as control. According to the PSI score, CAP divided into low risk group (0-90) in 30 cases, medium risk group (91-130 points) 11 cases of high-risk group, 14 cases (130); according to the CURB-65 score, divided into low risk group (O-1 or non-toxic HLP) in 41 cases, medium risk group (2 points, 6 cases with sepsis), high risk group (3-5 points, with severe sepsis or septic shock) 8 cases; according to the ATS adult CAP standard of severe pneumonia were divided into the severe pneumonia group (15 cases) and non severe pneumonia group (40 cases). ELISA method was used for quantitative detection of serum CPP level, serum C reactive protein determination of automatic biochemical analyzer (C-reactive protein, CRP), double antibody sandwich immunoassay for determination of serum procalcitonin (procalcitonin water, PCT) SPSS17.0 statistical software analysis showed that P0.05 was statistically significant.
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本文編號：1663269