降钙素原水平与C反应蛋白对重症慢性阻塞性肺疾病患者的预测价值  

Predictive value of procalcitonin level and C-reactive protein in patients with severe chronic obstructive pulmonary disease

作　　者：牛艳慧[1] 高勇[1] 王鑫[1] 邵丽娇 

机构地区：[1]河北省胸科医院重症医学科,河北石家庄050041

出　　处：《临床肺科杂志》2015年第8期1407-1409,共3页Journal of Clinical Pulmonary Medicine

基　　金：河北省医学科学研究重点课题(No 20130445)

摘　　要：目的研究血清降钙素原(PCT)水平、C反应蛋白(CRP)水平对重症慢性阻塞性肺疾病(简称慢阻肺)的预测价值。方法选取107例重症慢阻肺患者,测定初始及72 h PCT水平及CRP水平,按初始PCT水平分为PCT低水平组(PCT<0.5μg/L)和高水平组(PCT≥0.5μg/L),计算入ICU 24 h急性生理学与慢性健康状况评分系统Ⅱ(APACHEII)评分,比较两组APACHEⅡ评分、机械通气时间及28天病死率。按28天转归分为死亡组及存活组,观察各组PCT水平及CRP水平。结果 PCT高水平组APACHEⅡ评分、机械通气时间与28天病死率明显高于PCT低水平组,差异有统计学意义(P<0.01)。死亡组初始PCT水平及CRP水平均高于存活组,其中PCT水平有统计学意义,CRP水平无统计学意义。存活组72 h PCT水平及CRP水平均较初始水平下降,差异有统计学意义(P<0.01)。死亡组72 h PCT水平及CRP水平与初始水平相比无下降甚至有升高。结论 PCT水平及CRP水平对评估重症慢阻肺患者严重程度及预后具有一定的临床价值,动态变化意义更大。Objective To study the predictive value of serum procalcitonin and C-reactive protein levels in severe COPD patients. Methods 107 patients with severe COPD were selected, and their PCT and CRP levels were detected at the very beginning and 72 hours later. Then they were divided into two groups according to the initial PCT level： the low PCT level （PCT 〈 0. 5 μg/ L） and the high level group （PCT≥0. 5 μg/ L）. APACHEⅡ scores were recorded and compared between the two groups. The time of mechanical ventilation and the mortality within 28 days were compared too. After 28 days, they were divided into the death group and the survival group based on the 28-day follow-up. Results The APACHEⅡ scores, mechanical ventilation time and mortality were significantly higher in the PCT high level group than in the PCT low level group （P 〈 0. 01）. The initial levels of PCT and CRP were higher in the death group than in the survival group, but the level of CRP had no statistical significance. After 72 hours, the levels of PCT and CRP decreased significantly in the survival group （P 〈 0. 01）, but they didn′t change a lot in the death group or even higher. Conclusion The levels of PCT and CRP have certain predictive value to assess the se-verity and prognosis of patients with severe COPD.

关 键 词：降钙素原 C反应蛋白 重症慢阻肺 预后 

分 类 号：R563.9[医药卫生—呼吸系统]