血清降钙素原与C-反应蛋白对COPD急性期患者肺部细菌感染的临床诊断研究

发布时间：2018-02-02 18:14

本文关键词： 慢性阻塞性肺疾病急性加重期降钙素原 C-反应蛋白肺部细菌感染　出处：《中华医院感染学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的探讨降钙素原(PCT)、C-反应蛋白(CRP)对慢性阻塞性肺疾病急性加重期(AECOPD)患者细菌感染的诊断价值,以期为临床诊疗提供参考。方法选取2016年1月-2016年12月医院于呼吸重症监护室或呼吸内科住院的210例AECOPD患者,依据痰培养结果将患者分为痰培养阳性组(PC组)86例及痰培养阴性组(NC组)124例,检测两组患者临床指标,依据ROC曲线计算PCT、CRP最大约登指数对应的灵敏度及特异度。结果 PC组患者PCO2(58.6±11.7)mmHg显著高于NC组(53.1±10.8)mmHg,而SaO2(87.2±5.5)%则显著低于NC组(89.4±4.6)%(P0.05);PC组患者PCT(2.43±0.44)ng/mL、CRP浓度(108.5±18.4)mg/L均显著高于NC组(1.47±0.60)ng/mL、(95.5±12.5)mg/L(P0.05);PCT浓度ROC曲线结果显示,PCT最大约登指数为0.701,对应敏感度为91.9%,特异度为78.2%。结论 PCT对AECOPD患者细菌感染具有一定诊断价值,而CRP对AECOPD患者细菌感染的诊断价值尚待评估。
[Abstract]:Objective to evaluate the diagnostic value of procalcitonin (PCT) C-reactive protein (CRP) in the diagnosis of bacterial infection in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods from January 2016 to December 2016, 210 patients with AECOPD in respiratory intensive care unit or respiratory department were selected. According to the results of sputum culture, the patients were divided into PC group (86 cases) and negative sputum culture group (124 cases). The clinical indexes of the two groups were detected and the PCT was calculated according to the ROC curve. Results the PCO2(58.6 卤11.7hmHg in PC group was significantly higher than that in NC group (53.1 卤10.8mHg). However, SaO2(87.2 卤5.5% was significantly lower than that in NC group (89.4 卤4.6). PCT(2.43 卤0.44 ng / mL in PC group. The concentration of CRP (108.5 卤18.4 mg / L) was significantly higher than that of NC group (1.47 卤0.60 ng / mL, 95.5 卤12.5 mg / L, P < 0.05). The PCT concentration ROC curve showed that the maximum Jordan index was 0. 701 and the corresponding sensitivity was 91.9%. Conclusion PCT is valuable in the diagnosis of bacterial infection in patients with AECOPD, but the diagnostic value of CRP in bacterial infection in AECOPD patients needs to be evaluated.
【作者单位】：温州医科大学附属舟山医院呼吸科;温州医科大学附属第一医院呼吸科;温州医科大学附属舟山医院分子生物实验室;
【基金】：浙江省卫生科技计划基金资助项目(2016RCB020)
【分类号】：R563
【正文快照】： 为全世界导致患者死亡的主要原因之一[1],美国每年需花费50亿美元对COPD患者进行治疗,而其中约有60.00%用于治疗COPD急性加重期(AE-COPD)的患者[2]。AECOPD指COPD病程中患者短期内咳嗽、咳痰、气短和(或)喘息加重,痰量增多,痰液性状改变,可伴发热等炎症明显加重的表现[3]。而

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