PCT在肺结核与真菌性肺部感染疾病鉴别中的意义.docVIP

PCT在肺结核与真菌性肺部感染疾病鉴别中的意义 　　doi：10.3969/j.issn.1007-614x.2014.16.72 　　摘 要 目的：探讨PCT在肺结核与真菌性肺部感染疾病鉴别中的意义。方法：对50例肺结核患者（结核组）及50例真菌性肺部感染患者（真菌组）进行血清PCT、全血CRP、IL-6定量检测（采用免疫荧光定量检测方法），以PCT≥0.25ng/ml、CRP≥5mg/L、IL-6≥7pg/ml为阳性。结果：结核组血清PCT水平低于真菌组（P0.05）。结核组和真菌组中PCT的阳性率分别为20%和62%，差异有统计学意义（P0.01）。结论：血清PCT检测有助于肺结核与真菌性肺部感染的鉴别诊断。 　　关键词 肺结核 真菌性肺部感染 降钙素原 鉴别诊断 　　The significance of PCT in the differential diagnosis of pulmonary tuberculosis and pulmonary fungal infection 　　Luo Guohui1，2，Cao Huarui1，3，Xiao Jun4，Chen Xuerong1 　　Respiratory Medicine，West China Hospital of Sichuan University（Chengdu City，Sichuan），6100411 　　The Peoples Hospital of Meitan City，Guizhou 5641002 　　The Peoples Hospital of Shizhong District，Neijiang City，Sichuan 6410003 　　ICU Medicine，West China Hospital of Sichuan University（Chengdu City，Sichuan），6100414 　　Abstract Objective：To explore the significance of PCT in the differential diagnosis of pulmonary tuberculosis and pulmonary fungal infection.Methods：50 cases with pulmonary tuberculosis （tuberculosis group）and 50 cases with pulmonary fungal infection （fungal group）were selected.We measured their serum PCT，blood CRP，IL-6（the testing method of immunofluorescence quantitative）.PCT≥0.25ng/ml，CRP≥5mg/L，IL-6≥7pg/ml were positive.Results：The level of serum PCT in tuberculosis group was lower than that of fungal group（P0.05）.The positive rate of PCT of tuberculosis group and fungal group were 20% and 62% respectively，and the difference was statistically significant（P0.01）.Conclusion：Detection of serum PCT is helpful for pulmonary tuberculosis and pulmonary fungal infection in the differential diagnosis. 　　Key words Pulmonary tuberculosis；Pulmonary fungal infection；Procalcitonin；Differential diagnosis 　　肺结核是由结核分枝杆菌引起并威胁全人类健康的一种慢性传染病。近些年来，由于长期应用免疫抑制剂、抗结核药物、广谱抗生素、糖皮质激素，造成菌群失调、机体免疫功能不断下降，使得合并真菌性肺部感染发病率不断增加，在所有内脏真菌感染中呼吸系统真菌感染占据首位[1]。肺结核与真菌性肺部感染作为两种肺部的常见病，发生率有上升趋势，值得临床医师重视。本文回顾性分析我院住院确诊的肺结核患者和真菌性肺部感染患者各50例的临床资料，探讨早期鉴别诊断肺结核与真菌性肺部感染患者的PCT、CRP和IL-6在临床中的意义。 　　资料与方