D-二聚体和C-反应蛋白、白细胞计数水平在评价社区获得性肺炎患者严重程度及预后中的价值

CRP,D-dimer and leukocyte in evaluating the severity and prognosis of CAP

关键词:  社区获得性肺炎  D-二聚体  C-反应蛋白  预后

Key words:  community acquired pneumonia  D-dimer  C-reactive protein  prognosis

摘要:

［目的］探讨血浆D-二聚体、C-反应蛋白水平及白细胞计数在评价社区获得性肺炎（CAP）严重程度及预后中的价值。［方法］收集122例社区获得性肺炎患者的临床资料，测定患者血浆D-二聚体、C-反应蛋白（CRP）、白细胞水平及肺炎严重指数（pneumonia severity index，PSI）分级,按不同的病情严重程度标准对患者进行分组。比较肺炎严重指数（PSI）死亡低危组与高危组、重症肺炎组与非重症肺炎组、死亡组与生存组之间的差别。［结果］PSI死亡低危组与PSI死亡高危组之间血浆C-反应蛋白、D-二聚体比较差异有显著性意义，C-反应蛋白、D-二聚体水平重症肺炎组显著高于非重症肺炎组（P<0.01），死亡组高于生存组（P<0.01）。白细胞在以上各组间差异无显著性意义。D-二聚体与C-反应蛋白水平之间有相关性（r= 0.46，P<0.01），D-二聚体与预后之间有显著相关性（r=0.87，P<0.01）。［结论］血浆CRP、D-二聚体与社区获得性肺炎的严重程度具有相关性，并且D-二聚体水平可以较好的预测社区获得性肺炎患者预后。

Abstract:

［Objective］To investigate the value of C-reactive protein (CRP) and D-dimer levels and leukocyte count in evaluating the severity and prognosis of community acquired pneumonia (CAP).［Methods］One hundred and twenty-two patients with CAP were included in this study and their CRP,D-dimer and leukocytes were detected.Pneumonia severity index (PSI) were calculated.Low-risk and high-risk,severe and non-severe pneumonia,and fatal and non-fatal pneumonia among the patients were decided according to the different severity assessment criteria.［Results］CRP and D-dimer were significant different among PSI groups.The D-dimer and CRP levels were higher in severe group than these in non-severe group (P<0.01),and higher in fatal group than these in non-fatal group (P<0.01).Leukocyte count had no significant difference among groups.D-dimer had correlation with CRP (r= 0.46,P<0.01),and was correlated with prognosis remarkably (r=0.87,P<0.01).［Conclusion］Serum D-dimer and CRP levels correlate with the severity of CAP,and D-dimer level could predict prognosis better in patients with community-acquired pneumonia.