慢性阻塞性肺疾病急性加重期患者血清前降钙素原及C反应蛋白水平的变化及一年的随访研究  

Value of procalcitonin and C-reactive protein in acute exacerbation of chronic obstructive pulmonary disease

作　　者：孙国磊[1] 曹洁[1] 董丽霞[1] 陈宝元[1] 

机构地区：[1]天津医科大学总医院呼吸科,300052

出　　处：《国际呼吸杂志》2013年第7期513-517,共5页International Journal of Respiration

摘　　要：目的探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者血清前降钙素原（PCT）及C反应蛋白（cRP）水平与病情及短期预后的关系。方法55例cOPD患者，其中34例急性加重期患者为观察组，21例稳定期患者为对照组。采集两组血液样本，常规分离血清，采用酶联免疫荧光分析技术检测PCT，采用免疫散射比浊法检测CRP。比较两组患者血清PCT、CRP水平。观察组在用抗生素前留取痰液样本进行痰培养。比较观察组痰培养阳性与痰培养阴性患者血清PCT及CRP水平。对观察组患者出院后1年内的急性加重次数及距离第1次急性加重的天数进行随访；对急性加重次数及距离第1次急性加重的天数与PCT及CRP的水平进行线性相关分析；比较第1次急性加重在3个月内与3个月外患者的血清PCT及CRP水平。结果观察组与对照组患者的PCT及CRP的水平差异有统计学意义（1值分别为-4．468，-5．309；P值分别为0．000，0．000）；观察组痰培养阳性与痰培养阴性的患者PCT及CRP的水平差异无统计学意义（t值分别为0．146，一0．131；P值分别为0．885，0．896）；观察组治愈出院后1年内急性加重的次数与CRP及PCT呈正相关（r值分别为0．446、0．376，P值分别为0．011，0．034）；出院后距离下次急性加重的天数与CRP的水平呈负相关（r=-0．502，P=0．006），而与PCT没有显著相关性（r=-0．130，P=0．500）。此外，第一次急性加重在出院后3个月内的患者的CRP的水平高于3个月以外的急性加重的患者（t=2．368，P=0．024），而PCT差异无统计学意义（t=0．392，P=0．698）。结论COPD急性加重期患者体内的炎症反应增强。标记物的水平与临床预后有着显著的相关性。标记物的测定对于COPD的理解及预后均具有重要的意义。Objective Investigate the value of procalcitonin and C-reactive protein （CRP） for acute exacerbation chronic obstructive pulmonary disease （AECOPD） and analyse the relationship between procalcitonin and CRP and the short term prognosis of COPD. Methods A total of 55 cases of COPD patients were divided into observation group and control group. The observation group was 34 cases of acute exacerbation of patients, and the control group was 21 cases with stable patients. Two blood samples were collected, separated conventionally from the serum, using enzyme-linked fluorescent immunoassay to test PCT, by immune scattering turbidity for CRP. Compare the value of PCT and CRP between the two groups. In the observation group, sputum specimens for culture were collected before using antibiotics. Compare the value of PCT and CRP between positive and negtive of sputum culture of the observation group. In the observation group patients discharged within 1 year, the times of acute exacerbation and distance of first times of acute exacerbation were followed up. Linear correlation analyse were performed for the times of exacerbations and distance of first times of acute exacerbation and the value of PCT and CRP. Compare the value of PCT and CRP of the first acute exacerbation in and out of three months. Results There is significant difference between the observation group and the control groupof patients with PCT and CRP levels （ t = - 4. 468, 5. 309, P -0. 000,0. 000）. There is no significant difference between sputum culture negtive and positive of the observation group with PCT and CRP levels （ t =-0. 146,-0. 131, P =0. 885,0. 896）. In the observation group patients discharged within 1 year, the times of acute exacerbation is positively correlated with CRP and PCT levels（ r = 0. 446, 0. 376, P = 0. 011,0. 034）. After discharge from the hospital, the distance acute exacerbation next number of days with CRP levels are negatively correlated （r = -0. 502, P =0. 006） with the PCT, there is no significant co

关 键 词：慢性阻塞性肺疾病 急性加重 前降钙素原 C反应蛋白 急性加重次数 

分 类 号：R563.9[医药卫生—呼吸系统]