标题：感染合并心力衰竭患者降钙素原的水平及临床意义

      作者：陈宇锋 1，钟静敏 2，林 夏 1，魏 凯 1，周世峰 3，杨伟业 1，李春兰 4
    (1.茂名市人民医院检验科，广东 茂名 525000；
2.茂名市人民医院心内科，广东 茂名 525000；
3.茂名市中医院检验科，广东 茂名 525000；
4.茂名市中医院心内科，广东 茂名 525000)

      卷次： 2015年26卷9期

      【摘要】 目的 探讨降钙素原（PCT）检测对感染合并心力衰竭患者的诊断价值。方法 选择2013年8月1
日至2014年7月31日茂名市人民医院和中医院收治的185例感染合并心力衰竭患者为研究对象，将185例患者
根据病情分为感染合并心衰组、单纯感染组、单纯心衰组，另选择200例健康人群为对照组。检测各组的PCT和
C反应蛋白(CRP)水平。结果 感染合并心衰组患者的PCT水平明显高于其他三组(P<0.05)，单纯感染组、单纯
心衰组患者的PCT显著高于对照组(P<0.01)。感染合并心衰组患者的CRP水平明显高于其他三组(P<0.05)，且
单纯感染组、单纯心衰组患者的CRP水平显著高于对照组(P<0.01)，但单纯感染组、单纯心衰组间的CRP水平比
较差异无统计学意义(P>0.05)。Ⅳ级组PCT、CRP水平明显高于其他两组，且Ⅱ级组、Ⅲ级组组间PCT、CRP水平
比较差异亦具有统计学意义(P<0.05)。感染合并心力衰竭组PCT检测敏感性明显高于单纯感染组，且随着心力
衰竭级别增长，PCT检测敏感性呈上升趋势(P<0.05)。PCT检测适用于感染合并心力衰竭的诊断，但PCT的阳性
预测值随心衰程度的增大而呈现下降趋势。结论 检测PCT可有效诊断感染性疾病，感染合并心力衰竭会导致
检测数据偏高，因此在对感染合并心力衰竭患者监护的过程中应当严密观察其心功能状况及PCT水平。

      【关键词】 感染；心力衰竭；降钙素原；诊断

      【中图分类号】 R541.6 【文献标识码】 A 【文章编号】 1003—6350（2015）09—1310—04


Procalcitonin detection in the diagnosis of infection complicated with heart failure and its clinical significance.
CHEN
Yu-feng 1, ZHONG Jing-min2, LIN Xia 1, WEI Kai 1, ZHOU Shi-feng 3, YANG Wei-ye 1, LI Chun-lan 4. 1. Department of Clinical
Laboratory, People's Hospital of Maoming City, Maoming 525000, Guangdong, CHINA; 2. Department of Cardiology, People's
Hospital of Maoming City, Maoming 525000, Guangdong, CHINA; 3. Department of Clinical Laboratory, Hospital of Traditional
Chinese Medicine of Maoming City, Maoming 525000, Guangdong, CHINA; 4. Department of Cardiology, Hospital of Traditional
Chinese Medicine of Maoming City, Maoming 525000, Guangdong, CHINA

【Abstract】 Objective To explore the value of procalcitonin (PCT) detection in the diagnosis of infection
complicated with heart failure. Methods A total of 185 patients with infection heart complicated with failure
from August 1, 2013 to July 31, 2014 in People's Hospital of Maoming City and Hospital of Traditional Chinese
Medicine of Maoming City were selected as study sujects. The patients were divided into complicated group (in-
fection complicated with heart failure, group A), pure infection group (group B), pure heart failure group (group
C). Besides, 200 healthy people were selected as control group. PCT and C reactive protein (CRP) were detected.
Results PCT level of group was significantly higher than that of the other three groups, and the levels were sig-
nificantly higher in group B, group C than the control group (P<0.01). CRP level of group A was significantly
higher than that of the other three groups, and the levels were significantly higher in group B, group C than the
control group (P<0.01), with no significant difference between group B and group C (P>0.05). CRP and PCT lev-
els in Ⅳ stage heart failure group were significantly higher than that of Ⅱ stage heart failure group and Ⅲ stage
heart failure group, and the levels also showed statistically significant difference between Ⅱ stage heart failure
group and Ⅲ stage heart failure group (P<0.01). Detection sensitivity of PCT in complicated group was signifi-
cantly higher than that of pure infection group and pure heart failure group, and the detection sensitivity showed
an upward trend with growth of heart failure stage (P<0.05). PCT diagnosis is suitable for detecting patients with
infection complicated with heart failure, but the specificity and positive PCT test value showed a downward trend
with the degree of heart failure increasing (P<0.05). Conclusion Detecting procalcitonin can effectively diagnose
infectious disease. Infection complicated with heart failure may lead to high detection data. Therefore, for patients
with infection complicated with heart failure, heart function and PCT level should be in close observation.

      【Key words】 Infection; Heart failure; Procalcitonin; Diagnosis