C-反应蛋白联合降钙素原对慢性阻塞性肺病急性加重期中细菌感染的诊疗价值

发布时间：2018-11-15 22:08

【摘要】：目的:观察慢性阻塞性肺病急性加重期(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)患者血清中C-反应蛋白(C-reactiveprotein,CRP)和降钙素原(procalcitionin,PCT)的水平变化,探讨CRP联合PCT检测在AECOPD细菌感染中的诊疗价值。方法:选取湖南师范大学附属湘东医院呼吸科2011年1月至2012年12月间收治的369例AECOPD患者,对比200例感染患者及169例非感染患者治疗前后血清CRP,PCT,白细胞总数(WBC),血沉(ESR)及中性粒细胞百分比(N)指标变化情况,分析CRP及PCT水平变化与AECOPD细菌感染的关系。结果:感染组AEPOD患者治疗前CRP,PCT,ESR,WBC及N的水平均显著高于非感染组AECOPD患者(P0.05或P0.01),ESR水平差异无统计学意义(P0.05)。感染组AECOPD患者CRP,PCT,ESR,WBC及N的水平显著低于治疗前(P0.05)。治疗后感染组患者CRP,PCT,WBC及N的水平显著高于非感染组患者(P0.05),而ESR水平两组间差异无统计学意义(P0.05)。PCT与CRP,ESR,WBC呈正相关(r分别为0.46,0.38,0.20;P0.05),与N无关;CRP与WBC,N及ESR呈正相关(r分别为0.56,0.43,0.30;P0.05)。结论:CRP联合PCT检测是判断AECOPD患者是否合并细菌感染敏感性较高、特异性较强的指标,同时也为AECOPD患者的治疗和预后评估提供了临床指导。
[Abstract]:Objective: to observe the changes of serum C-reactive protein (C-reactive protein) and procalcitonin (procalcitionin,PCT) levels in patients with acute exacerbation of chronic obstructive pulmonary disease (acute exacerbations of chronic obstructive pulmonary disease,AECOPD). To explore the value of CRP combined with PCT in the diagnosis and treatment of AECOPD bacterial infection. Methods: from January 2011 to December 2012, 369 patients with AECOPD were selected from Department of Respiratory, Xiangdong Hospital affiliated to Hunan normal University. The total (WBC), of serum CRP,PCT, leucocytes was compared between 200 infected patients and 169 non-infected patients before and after treatment. The changes of ESR (ESR) and neutrophil percentage (N) were analyzed. The relationship between the changes of CRP and PCT levels and AECOPD bacterial infection was analyzed. Results: the levels of CRP,PCT,ESR,WBC and N in AEPOD patients before treatment were significantly higher than those in AECOPD patients without infection (P0.05 or P0.01), ESR) (P0.05). The levels of CRP,PCT,ESR,WBC and N in AECOPD patients were significantly lower than those before treatment (P0.05). The levels of CRP,PCT,WBC and N in infected patients after treatment were significantly higher than those in non-infected patients (P0.05), but there was no significant difference in ESR levels between the two groups (P0.05 between). PCT and CRP,ESR,). WBC was positively correlated (r = 0.46, 0.38, 0.20, respectively); CRP was positively correlated with WBC,N and ESR (r = 0. 56). Conclusion: CRP combined with PCT is a sensitive and specific index to judge whether AECOPD patients are complicated with bacterial infection. It also provides clinical guidance for the treatment and prognosis evaluation of AECOPD patients.
【作者单位】：湖南师范大学附属湘东医院呼吸科;中南大学湘雅医院呼吸科;
【分类号】：R563.9

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