Abstract：【Objective】 To explore the application value of lung ultrasound combined with procalcitonin (PCT) and C-reactive protein (CRP) detection in patients with severe pneumonia complicated by acute respiratory distress syndrome (ARDS). 【Methods】 A total of 198 patients with severe pneumonia admitted to our hospital from February 2018 to October 2020 were selected as the severe pneumonia group. During the same time period, 185 patients with common pneumonia in our hospital and 182 healthy volunteers were recruited as the common pneumonia group and the healthy control group. The lung ultrasound scores, PCT and CRP levels were compared among three groups. According to whether patients with severe pneumonia complicated with ARDS, they were divided into the concurrent group and non-complicated group. And the clinical data of the two groups were compared. Logistic multivariate regression was used to analyze the factors affecting severe pneumonia complicated with ARDS. A receiver operating characteristic curve (ROC) was made to analyze the diagnostic value of combined detection of lung ultrasound score, PCT and CRP levels for severe pneumonia complicated by ARDS. 【Results】 The lung ultrasound scores, PCT and CRP levels of the three groups were statistically different (P<0.05). The lung ultrasound scores, PCT and CRP levels of patients in the severe pneumonia group were significantly higher than those of the common pneumonia group and the healthy group (P<0.05). The lung ultrasound scores, PCT and CRP levels of the patients in the common pneumonia group were significantly higher than those of the healthy group (P<0.05). The incidence of severe pneumonia complicated by ARDS was 37.37%. The time of ICU stay, usage of mechanical ventilation, interleukin-6, white blood cell count (WBC), severity of pneumonia (PSI) score, acute physiology and chronic health score system Ⅱ(APACHE Ⅱ) score, lung ultrasound score, and levels of PCT and CRP in patients of the concurrent group were significantly higher than those of the non-complicated group (P<0.05). Logistic regression analysis and multivariate analysis showed that the length of admission to ICU, PSI score, lung ultrasound, and serum levels of PCT and CRP were all factors affecting severe pneumonia complicated by ARDS (OR=3.518, 3.900, 2.776, 4.415, 4.187, P< 0.05). ROC analysis showed that specificity the combination of the lung ultrasound, PCT level and CRP level was higher than the specificity of lung ultrasound, PCT level and CRP level separately evaluated. The area under the curve (AUC) for severe pneumonia complicated with ARDS detected by lung ultrasound combined with PCT and CRP level detection was 0.916, which was significantly higher than the AUC diagnosed by lung ultrasound, PCT and CRP alone (0.770, 0.812 and 0.767,respectively) (P<0.05). 【Conclusion】 Lung ultrasound combined with PCT and CRP have high diagnostic efficiency for severe pneumonia complicated by ARDS. It can be used as an important reference index for the diagnosis of severe pneumonia complicated by ARDS.
刘晓晖, 高洪亮, 白雪. 肺部超声检查联合PCT、CRP检测在重症肺炎并发ARDS患者中的应用价值[J]. 医学临床研究, 2022, 39(5): 701-704.
LIU Xiao-hui, GAO Hong-liang, BAI Xue. Application of Lung Ultrasound with PCT and CRP Combined Detection in Patients with Severe Pneumonia Complicated with ARDS. JOURNAL OF CLINICAL RESEARCH, 2022, 39(5): 701-704.
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2022, Vol. 39 
