PCT、CRP在慢性阻塞性肺疾病急性加重期的变化及相关性分析

发布时间：2018-06-17 10:25

本文选题：慢性阻塞性肺疾病 + 急性加重　；参考：《昆明医科大学》2015年硕士论文

【摘要】：目的：观察降钙素原(Procalcitonin, PCT)、C-反应蛋白(C-reactive protein,CRP)在慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)的变化及相关性,了解其对评估AECOPD严重程度、AECOPD合并肺炎的诊断等的参考价值。方法：按照设计的要求,选取2013年9月至2014年12月在昆明医科大学第一附属医院呼吸内科住院的COPD患者219例,分为AECOPD组(n=106)和AECOPD伴肺炎组(n=113)两组。其中AECOPD组按照2014年慢性阻塞性肺疾病全球倡议(The Global Initiative for Chronic Obstructive Lung Disease, GOLD)标准分为AECOPD-B组(n=33)、C组(n=30)、D组(n=43)三组。检测和收集AECOPD组、AECOPD伴肺炎组两组患者的白细胞(White blood cells, WBC)水平、中性粒细胞(Neutrophils, N)百分数水平、PCT水平,CRP水平、住院时间、抗菌治疗疗程、住院费用等,再将PCT、CRP分别与上述其余指标的相关性进行分析。结果：1、AECOPD伴肺炎组的WBC、N、PCT、住院时间、抗菌治疗疗程、住院费用明显高于AECOPD组,差异有统计学意义(P0.05),两组CRP的差异无统计学意义(P0.05)。2、AECOPD组PCT与住院时间、抗菌治疗疗程、住院费用存在一定正相关关系(r=0.32、0.32、0.231,P0.05),与WBC、N.CRP无相关性(P0.05), CRP与WBC、N存在一定正相关关系(r=0.372、0.209,P0.05),与PCT、住院时间、抗菌治疗疗程、住院费用无相关性(P0.05)。AECOPD伴肺炎组患者PCT与WBC, N, CRP存在一定正相关关系(r=0.202、0.309、0.293,P0.05),与住院时间、抗菌治疗疗程、住院费用无相关性(P0.05), CRP与WBC、N、PCT存在一定正相关关系(r=0.299、0.35、0.293,P0.05),与住院时间、抗菌治疗疗程、住院费用无相关性(P0.05)。3、AECOPD-B、C、D三组的PCT水平不全相同,差异有统计学意义(P0.05),三组CRP水平差异无统计学意义(P0.05)。PCT:D组C组=B组,B组与C组PCT水平差异无统计学意义(P0.017),B组与D组,C组与D组PCT水平差异均有统计学意义(P0.017)。结论：1、PCT联合WBC、N、CRP对AECOPD伴肺炎的诊断可能起辅助作用。2、PCT对AECOPD的住院时间、抗菌治疗疗程、住院费用可能有参考价值。3、PCT对AECOPD病情严重程度的评估可能有指导意义。
[Abstract]:Objective: to observe the changes and correlation of procalcitonin (PCT) C-reactive protein (CRP) in acute exacerbation of chronic obstructive pulmonary disease (COPD) and its value in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the severity of AECOPD and the diagnosis of AECOPD complicated with pneumonia. Methods: according to the design requirements, 219 COPD patients admitted to Department of Respiratory Medicine, first affiliated Hospital of Kunming Medical University from September 2013 to December 2014, were divided into two groups: AECOPD group (n = 106) and AECOPD with pneumonia group (n = 113). The AECOPD group was divided into three groups according to the Global Initiative for chronic obstructive Pulmonary Disease (for structural Lung Disease4, GOLDD) standard: AECOPD-B group (AECOPD-B group) and group C (group C). White blood cells (WBCs), neutrophiles (N) percentage, duration of stay, course of antimicrobial treatment, hospitalization cost, etc were measured and collected in AECOPD patients with pneumonia. The correlation between PCTU CRP and the above mentioned indexes was analyzed. Results the duration of hospitalization, the course of antimicrobial treatment, and the cost of hospitalization in the WBCCn with pneumonia group were significantly higher than those in the AECOPD group (P 0.05). There was no significant difference in CRP between the two groups. There was no significant difference between the two groups in terms of PCT, hospitalization time, antimicrobial treatment course. There was a positive correlation between the cost of hospitalization and WBCN, there was a positive correlation between CRP and WBCN, there was a positive correlation between CRP and WBCN, there was a positive correlation between CRP and WBCN, and there was a positive correlation between CRP and PCT, hospital stay time, antibacterial treatment course, and there was a positive correlation between CRP and WBCN. There was a positive correlation between PCT and WBC, N-, CRP in patients with pneumonia. There was a positive correlation between PCT and WBC, N-, CRP in patients with pneumonia. There was no correlation between PCT and duration of hospitalization, course of antimicrobial treatment, cost of hospitalization (P0.05), CRP and WBCNPCT, there was a positive correlation between CRP and WBCNPCT, and there was a positive correlation between CRP and duration of hospitalization, and there was a positive correlation between CRP and WBCNPCT, and there was a positive correlation between CRP and duration of hospitalization, and there was no correlation between CRP and WBCNPCT, and there was a positive correlation between CRP and WBCNPCT. In the course of antibacterial treatment, the PCT levels of the three groups were not all the same as those of the three groups (P0.05, P 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05), There was no significant difference in the levels of CRP among the three groups. There was no significant difference in the levels of PCT between group C and group C, group B and group C; there was no significant difference in the levels of PCT between group B and group C; there was no significant difference in the levels of PCT between group C and group D in group B and group D. There were significant differences in the levels of PCT between group C and group D. Conclusion the ratio of 1 / 1 PCT combined with WBCfN / CRP may play an auxiliary role in the diagnosis of AECOPD with pneumonia. The duration of hospitalization, the course of antimicrobial therapy and the cost of hospitalization may be helpful to evaluate the severity of AECOPD. 3. [WT5 "HZ] [WT5" BZ] [WT5 "BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ]
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R563.9

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