降钙素原与超敏C反应蛋白在AECOPD中的临床价值

发布时间：2018-03-28 13:55

本文选题：降钙素原　切入点：超敏　出处：《安徽医科大学》2015年硕士论文

【摘要】：目的降钙素原(PCT)由甲状腺C细胞生成,正常情况下其值较低,在病理情况下则由甲状腺以外的组织生成,如肺、肝、肌肉等,在细菌感染时其值升高,尤其在脓毒血症是变化更为明显。超敏C反应蛋白(Hs-CRP)主要由肝细胞合成,是一种非特异性急性时相反应性蛋白,参与机体的多项病理生理反应,正常情况下其在血清的浓度极低,在炎症、感染时,其血清值会迅速升高,发挥抗炎作用,病情控制后迅速下降。本文主要探讨血清PCT与hs-CRP在慢性阻塞性肺疾病急性加重期(AECOPD)临床应用价值。方法选择我院78例AECOPD住院病人(2013年2月-2014年2月在安徽医科大学阜阳临床学院呼吸科住院治疗的AECOPD患者)及34例门诊随访的慢性阻塞性肺疾病(COPD)稳定期患者,分别测定AECOPD患者入院治疗前及第10天的血清PCT及hs-CRP水平,以及稳定期患者的血清PCT、hs-CRP的浓度。应用慢阻肺评估测试(CAT)评分系统评估观察组病人治疗前后的病情,并同治疗前后PCT及hs-CRP血清水平变化作相关性分析。结果AECOPD患者治疗前血清PCT、hs-CRP的浓度(两者均数分别为1.07±0.70、2.34±1.34)明显高于治疗后(均数分别为0.30±0.19、1.42±1.21)及稳定期患者(均数分别为0.28±0.15、0.83±0.31),并且其诊断阳性率较高,分别80.8%、75.6%,慢性阻塞性肺疾病急性加重期患者治疗前后的两者血清水平变化量同治疗前后患者病情变化有明显的相关性(相关性分别为0.88、0.70)。结论血清PCT及hs-CRP水平测定是诊断慢性阻塞性肺疾病急性加重的较为敏感指标,并对评估AECOPD患者治疗前后病情变化有重要价值,联合检测血清PCT和hs-CRP对AECOPD患者有重要的临床意义。
[Abstract]:Objective to produce procalcitonin (PCT) from C cells of thyroid gland, which is lower in normal condition and higher in tissues outside thyroid gland in pathological condition, such as lung, liver, muscle, etc. Especially in sepsis, the changes of Hs-CRP are more obvious. Hs-CRP is mainly synthesized by hepatocytes and is a non-specific acute phase reactive protein, which is involved in many pathophysiological reactions. Under normal circumstances, its concentration in the serum is extremely low, and when it is inflamed and infected, its serum value will rise rapidly and play an anti-inflammatory role. The clinical value of serum PCT and hs-CRP in acute exacerbation of chronic obstructive pulmonary disease (COPD) was investigated. Methods 78 AECOPD inpatients in Anhui Medical University from February 2013 to February 2014 were selected. And 34 patients with chronic obstructive pulmonary disease (COPD) who were hospitalized in the respiratory department of Fuyang Clinic, and 34 patients with chronic obstructive Pulmonary Disease (COPD) in outpatient follow-up. The levels of serum PCT and hs-CRP were measured before and 10 days after admission of AECOPD patients, and the serum levels of PCThs-CRP in stable patients were measured respectively. The patients in the observation group were evaluated before and after treatment with the slow obstructive pulmonary assessment (COPD) scoring system. Results before and after treatment, the serum levels of PCT and hs-CRP in AECOPD patients (mean 1.07 卤0.70 卤2.34 卤1.34) were significantly higher than those after treatment (0.30 卤0.19 卤1.42 卤1.21) and stable phase patients (mean, respectively). The positive rate was 0.28 卤0.15 ~ 0.83 卤0.31, and the positive rate was higher. The changes of serum levels in patients with acute exacerbation of chronic obstructive pulmonary disease before and after treatment were significantly correlated with those of patients with chronic obstructive pulmonary disease before and after treatment (the correlation was 0.880.700.Conclusion the levels of serum PCT and hs-CRP were determined in patients with acute exacerbation of chronic obstructive pulmonary disease before and after treatment. A sensitive indicator for the diagnosis of acute exacerbation of chronic obstructive pulmonary disease, It is of great value to evaluate the changes of AECOPD patients before and after treatment. The combined detection of serum PCT and hs-CRP is of great clinical significance for AECOPD patients.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R563.9

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