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检测 PTX3 对社区获得性肺炎的临床意义研究。

Investigation of the clinical significance of detecting PTX3 for community-acquired pneumonia.

机构信息

Clinical Skills Training Center, Rizhao Hospital of TCM, Rizhao, China.

出版信息

Eur Rev Med Pharmacol Sci. 2020 Aug;24(16):8477-8482. doi: 10.26355/eurrev_202008_22645.

Abstract

OBJECTIVE

To evaluate the value of PTX3 in the diagnosis of community-acquired pneumonia (CAP).

PATIENTS AND METHODS

We included 170 inpatients diagnosed with CAP from January 2016 to December 2018. The patients were divided into the severe pneumonia group and the mild pneumonia group according to their condition. According to the results of pathogen detection, they were divided into the bacterial infection group, the virus infection group, the mixed infection group, and the other pathogen infection group. Clinical data including C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), and neutrophil-lymphocyte ratio (NLR) were collected. Blood was collected within 24 hours, 3 days, and 7 days after admission, and the serum PTX3 level was dynamically monitored. The correlation between different groups was compared, and expression differences and dynamic changes of PTX3 were analyzed.

RESULTS

PTX3, PCT, and CRP in the CAP group were higher than those in the healthy control group, and the difference was statistically significant (p<0.05). Compared with the mild group, the increase of PTX3, PCT, and CRP was also different in the severe group (p<0.05). The area under the ROC curve of PTX3 was 0.726 (sensitivity 76.08%, specificity 76.92%) when the threshold value was 32.26 ng/ml. Dynamic monitoring of PTX3 showed that the PTX3 level in severe CAP patients was significantly higher than that in mild patients (p<0.05), and the PTX3 level in both groups gradually decreased with treatment time, but the level in severe CAP patients remained at a high level on the 7th day. The main pathogens in CAP were bacteria (77 cases, 45.7%), and there was no significant difference in the PTX3 level among the patients infected with different pathogenic bacteria (p=0.311).

CONCLUSIONS

The serum PTX3 level, especially the dynamic monitoring results, can be used as a biomarker to reflect community acquired pneumonia, which can provide effective auxiliary diagnosis and efficacy in monitoring for clinical practice.

摘要

目的

评估 P 选择素蛋白三型(PTX3)在社区获得性肺炎(CAP)诊断中的价值。

患者和方法

我们纳入了 2016 年 1 月至 2018 年 12 月期间因 CAP 住院的 170 例患者。根据病情将患者分为重症肺炎组和轻症肺炎组。根据病原体检测结果,将患者分为细菌感染组、病毒感染组、混合感染组和其他病原体感染组。收集包括 C 反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)和中性粒细胞/淋巴细胞比值(NLR)在内的临床数据。入院后 24 小时、3 天和 7 天采集血液,动态监测血清 PTX3 水平。比较不同组之间的相关性,并分析 PTX3 的表达差异和动态变化。

结果

CAP 组的 PTX3、PCT 和 CRP 高于健康对照组,差异具有统计学意义(p<0.05)。与轻症组相比,重症组的 PTX3、PCT 和 CRP 升高也不同(p<0.05)。PTX3 截断值为 32.26ng/ml 时,ROC 曲线下面积为 0.726(灵敏度 76.08%,特异性 76.92%)。PTX3 的动态监测显示,重症 CAP 患者的 PTX3 水平明显高于轻症患者(p<0.05),且两组患者的 PTX3 水平随治疗时间逐渐降低,但重症 CAP 患者的水平在第 7 天仍处于较高水平。CAP 的主要病原体为细菌(77 例,45.7%),不同病原体感染患者的 PTX3 水平无显著差异(p=0.311)。

结论

血清 PTX3 水平,尤其是动态监测结果,可作为反映社区获得性肺炎的生物标志物,为临床实践提供有效的辅助诊断和疗效监测。

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