Objective To explore the clinical value of serum hs-CRP, cTnI and D-D levels in the patients with community acquired pneumonia (CAP).Methods 133 patients with CAP of bacterial strain infection were divided into 3 groups, 63 with gram negative bacterial strains infection, 39 with gram positive bacterial strains infection and 31 with strains fungi infection. The serum hs-CRP, cTnI and D-D levels in 133 patients with CAP and 60 healthy controls were determined by radioimmunoassay, chemiluminescence immunoassay and immunoturbidimetry with compared analysis.Results The serum hs-CRP level in CAP patients was signiifcantly higher than those in control group (P<0.001), the serum hs-CRP level in gram negative bacterial strains infection group was higher than those in gram positive bacterial strains infection group and strains fungi infection group (P<0.05,P<0.01). The serum hs-CRP level in gram positive bacterial strains infection group was higher than those in strains fungi infection group (P<0.05) so that the serum hs-CRP possessed early identiifcation diagnosis forbacterial strains. The serum cTnI and D-D levels in CAP patients were signiifcantly higher than those in control group (P<0.001 and<0.01). The serum cTnI and D-D levels in gram negative bacterial strains infection group were higher than those in gram positive bacterial strains infection group and strains fungi infection group (P all<0.05), but there was no signiifcant difference between gram positive bacterial strains infection group and strains fungi infection group (P>0.05).Conclusion The serum hs-CRP, cTnI and D-D levels in CAP patients were a valuable index for early diagnosis, but the serum hs-CRP was best in identiifcation diagnosis of bacterial strains.%目的：探讨社区获得性肺炎（community acquired pneumonia, CAP）患者血清高敏C反应蛋白（high-sensitivity C-reactive protein, hs-CRP），肌钙蛋白I（cardiac troponin I, cTnI）和D-二聚体（D-dimer, D-D）水平的临床意义。方法133例CAP患者经细菌培养分成63例革兰阴性菌感染组、39例革兰阳性菌感染组和31例真菌感染组。采用放射免疫分析、化学发光免疫分析和免疫比浊分析分别测定133例CAP患者和60例对照组血清hs-CRP、cTnI和D-D水平，并进行对比性研究。结果 CAP患者血清hs-CRP水平显著高于对照组（P＜0.001），其中革兰阴性菌感染组血清hs-CRP水平显著高于革兰阳性菌感染组和真菌感染组（P＜0.05，P＜0.01），革兰阳性菌感染组血清hs-CRP水平显著高于真菌感染组（P＜0.05），故血清hs-CRP水平具有病原体早期诊断和鉴别诊断临床价值。CAP患者血清cTnI和D-D水平显著高于对照组（P＜0.001，P＜0.01），革兰阴性菌感染组血清cTnI和D-D水平显著高于真菌感染组（P均＜0.05），而革兰阳性菌感染组较之真菌感染组差异无统计学意义（P＞0.05）。结论血清hs-CRP、cTnI和D-D水平是早期诊断CAP患者的有价值指标，病原体的鉴别诊断以血清hs-CRP水平为好。
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