Niclas Johansson, Mats Kalin, Carolina Backman-Johansson, Anders Larsson, Kristina Nilsson, Jonas Hedlund
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引用次数: 28
摘要
我们研究了社区获得性肺炎(CAP)患者入院时降钙素原(PCT)水平及其与病因和严重程度的关系。菌血症患者的中位PCT浓度高于非菌血症患者(6.11 μg/L vs 0.34 μg/L, p = 0.0002),非菌血症肺炎球菌病因患者的中位PCT浓度高于其他经典细菌感染患者(1.18 vs 0.18, p = 0.038),肺炎球菌病因患者的中位PCT浓度高于病毒病因患者(2.43 vs 0.24, p = 0.017)。当病因学、菌血症和肺炎严重程度指数(PSI)的严重程度纳入logistic回归分析,PCT > 0.5为因变量时,非细菌性肺炎球菌病因学的优势比(OR)为5.7 (p = 0.008), PSI 4-5的优势比(OR)为3.0 (p = 0.1)。对菌血症和PSI 4-5的单独分析显示OR分别为17.5 (p = 0.008)和2.7 (p = 0.092)。在CAP患者中,高PCT似乎是侵袭性疾病和肺炎球菌病因学的良好标志。作为严重程度的预测指标,它似乎不那么重要了。
Procalcitonin levels in community-acquired pneumonia - correlation with aetiology and severity.
We studied procalcitonin (PCT) levels at hospital admittance and their association with aetiology and severity in patients with community-acquired pneumonia (CAP). Median PCT concentrations were higher in bacteraemic patients than in those without bacteraemia (6.11 μg/L vs 0.34 μg/L, p = 0.0002), in patients with non-bacteraemic pneumococcal aetiology than in those infected with other classic bacteria (1.18 vs 0.18, p = 0.038), and in patients with pneumococcal as compared with viral aetiology (2.43 vs 0.24, p = 0.017). When aetiology, bacteraemia and severity according to the pneumonia severity index (PSI) were included in logistic regression analyses with PCT > 0.5 as a dependent variable, the odds ratio (OR) for non-bacteraemic pneumococcal aetiology was 5.7 (p = 0.008) and 3.0 ( p = 0.1) for PSI 4-5. A separate analysis for bacteraemia and PSI 4-5 showed an OR of 17.5 (p = 0.008) and 2.7 (p = 0.092), respectively. In CAP patients, high PCT seems to be a good marker for invasive disease and pneumococcal aetiology. As a predictor of severity it appears to be less important.