慢性阻塞性肺疾病急性加重期患者血清降钙素原和C反应蛋白检测的临床意义  

Clinical significance of serum PCT and CRP detection in Patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)

作　　者：叶春幸[1] 林华胜[2] 卓宋明[1] 孙俊生[1] 马真[1] 申严[1] 李娜[1] 

机构地区：[1]广东省深圳市龙岗中心医院呼吸内科,广东深圳518116 [2]广东医学院病原生物学实验室,广东湛江504023

出　　处：《广东医学院学报》2015年第2期163-166,共4页Journal of Guangdong Medical College

摘　　要：目的探讨血清降钙素原(PCT)、C反应蛋白(CRP)检测在慢性阻塞性肺疾病急性加重期(AECOPD)诊治中临床意义。方法对83例AECOPD患者(AECOPD组)和40例慢性阻塞性肺疾病(COPD)患者(COPD组)进行血清PCT和CRP检测,并对AECOPD组进行胸片检查。(1)比较AECOPD组治疗前后以及AECOPD组与COPD组患者的血清PCT、CRP水平;(2)比较合并和不合并肺炎AECOPD患者上述两项指标;(3)对AECOPD组患者出院后随访1 a,比较出院后3个月内和3个月后急性加重患者、1 a内急性加重1次和1 a内急性加重>1次患者之间治疗前血清PCT、CRP水平。结果 (1)治疗前,AECOPD组血清PCT、CRP水平高于COPD组(P<0.01);治疗后AECOPD组血清PCT、CRP水平较治疗前显著下降(P<0.01),CRP水平仍高于COPD组(P<0.01),PCT水平与COPD组比较差异无统计学意义(P>0.05);合并肺炎组血清PCT、CRP水平均高于不合并肺炎组(P<0.01),出院后3个月内加重患者的血清PCT、CRP水平高于3个月后急性加重患者(P<0.01),1 a内急性加重>1次患者血清PCT、CRP水平高于急性加重1次患者(P<0.01)。结论 PCT、CRP可能参与AECOPD发生的病理过程,两种血清标志物的检测对于AECOPD诊断、病情判断及短期预后的评估具有重要意义。Objective To explore the clinical significance of serum procalcitonin（PCT） and C reactive protein（CRP） detection in the diagnosis and treatment of patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods 83 patients with AECOPD（Group AECOPD） and 40 patients with chronic obstructive pulmonary disease（COPD）（Group COPD） underwent serum PCT and CRP detection and the patients in Group AECOPD underwent chest X-ray scanning.（1） Serum PCT and CRP levels of the AECOPD group before and after treatment, and those between Group COPD and Group AECOPD were compare;（2） The patients complicated with pneumonia were compared with those not complicated with pneumonia were compared in terms of abovementioned two indicators;（3） The discharged patients of Group AECOPD were followed up for 1 year. The serum PCT and CRP levels of the patients with acute exacerbation within 3 months and after 3 months, and those of the patients with acute exacerbation for once and for more than once within 1 a were compared. ResultsBefore treatment, the serum PCT and CRP levels of Group AECOPD were higher than those of Group COPD（P〈0.01）; after treatment, the serum PCT and CRP levels of Group AECOPD were significantly decreased compared with those before treatment（P〈0.01）, the CRP level of Group AECOPD was higher than that of Group COPD（P〈0.01）, and there was no significant difference between the two groups in terms of PCT level（P〈0.05）; The serum PCT and CRP levels of the group complicated with pneumonia were higher than those of the group not complicated with pneumonia（P〈0.01）, the serum PCT and CRP levels of the patients with acute exacerbation within 3 months upon discharge were higher than those of the patients with acute exacerbation after 3 months upon discharge（P〈0.01）, and the patients with acute exacerbation for once within 1 a were higher than those of patients with acute exacerbation more than once within 1 a（P〈0.01）. Conclusion PCT

关 键 词：慢性阻塞性肺疾病 降钙素原 C反应蛋白 

分 类 号：R563.9[医药卫生—呼吸系统]