目的评估降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)和内毒素(endotoxin,ET)联合检测对重症细菌性肺炎的诊断和疗效。方法依据重症肺炎诊断标准,本研究收集了2012年12月—2014年6月本院80例临床重症肺炎患者,细菌性肺炎组50例和非细菌性肺炎组30例。细菌性肺炎组为G-菌感染肺炎,分别采用发光免疫分析法、免疫透射比浊法、动态浊度鲎试剂法测定患者血清的PCT、CRP和ET水平;比较细菌性肺炎组50例在治疗前后PCT、CRP和ET水平的变化,计量资料采用t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果细菌性肺炎组PCT、ET、CRP水平较非细菌性肺炎组均明显升高,对比差异有统计学意义(P<0.05)。G-菌感染肺炎经抗生素有效治疗后,PCT、CRP、ET水平均下降,治疗前后对比差异均有统计学意义(均P<0.05)。结论 PCT、CRP和ET炎症指标都对重症肺炎的诊断和预后评估有一定的意义。 Objective To evaluate the diagnostic and curative effect of combined detection of procalcitonin (PCT), C-reactive protein (CRP) and endotoxin (ET) on severe bacterial pneumonia. Methods According to the diagnostic criteria of severe pneumonia, 80 cases of clinical severe pneumonia, 50 cases of bacterial pneumonia and 30 cases of non-bacterial pneumonia were collected from December 2012 to June 2014 in our hospital. Bacterial pneumonia group was G-bacteria-infected pneumonia, and the levels of PCT, CRP and ET were measured by luminescence immunoassay, immunoturbidimetric assay and dynamic turbidimetric assay respectively. 50 patients in bacterial pneumonia group were treated Before and after PCT, CRP and ET levels changes, measurement data using t test, count data usingχ ~ 2 test, P <0.05 for the difference was statistically significant. Results The bacterial pneumonia group PCT, ET, CRP levels were significantly higher than non-bacterial pneumonia group, the difference was statistically significant (P <0.05). The levels of PCT, CRP and ET in the G-bacteria-infected pneumonia after effective antibiotics treatment decreased, and the differences between the two groups were statistically significant (all P <0.05). Conclusions The indexes of inflammation of PCT, CRP and ET have certain significance in the diagnosis and prognosis evaluation of severe pneumonia.