慢性阻塞性肺疾病急性加重期患者血清PCT、hs-CRP、D-D和FIB与肺功能和预后的关系研究  

Relationship between Serum PCT,hs-CRP,D-D and FIB and Lung Function and Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：周璇[1] 杨万春[1] 王勇生 江银玲[1] 吕志[1] 赵雷 ZHOU Xuan;YANG Wan-chun;WANG Yong-sheng;JIANG Yin-ling;LV Zhi;ZHAO Lei(Department of Respiratory Medicine,Hefei Second People's Hospital,Hefei,Anhui,230011,China)

机构地区：[1]合肥市第二人民医院呼吸内科,安徽合肥230011

出　　处：《现代生物医学进展》2020年第16期3168-3171,3137,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金面上项目(81373072);安徽省高等学校青年科学基金项目(2019xkj085);安徽省高等学校自然科学类重点项目(BYKY2019300ZD)。

摘　　要：目的:探究慢性阻塞性肺疾病急性加重期(AECOPD)患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)和纤维蛋白原(FIB)与肺功能和预后的关系。方法:选择2017年8月至2019年8月期间我院诊治的88例AECOPD患者作为观察组,根据患者生存情况将患者进一步分为85例存活组和3例死亡组。同时选择同期在我院进行健康体检的50名志愿者作为对照组。检测各组患者的血清PCT、hs-CRP、D-D和FIB水平,采用肺功能检测仪检测第一秒用力呼气容积(FEV1)%、第一秒用力呼气容积占用力肺活量比值(FEV1/FVC)和最大通气量(MVV)肺功能指标,采用Pearson相关性分析进行各指标的相关性分析。结果:与对照组相比,观察组的血清PCT、hs-CRP、D-D和FIB水平均明显升高(P<0.05)。与存活组相比,死亡组的血清PCT、hs-CRP、D-D和FIB水平均明显升高(P<0.05),FEV1%、FEV1/FVC和MVV指标均明显下降(P<0.05)。Pearson相关性分析显示,血清PCT、hs-CRP、D-D和FIB水平均与FEV1%、FEV1/FVC和MVV肺功能指标呈负相关(P<0.05)。结论:AECOPD患者肺功能下降和不良预后与血清PCT、hs-CRP、D-D和FIB水平升高密切相关,在AECOPD患者的预后预测中具有一定临床价值。Objective:To investigate the relationship between serum Procalcitonin(PCT),high sensitive C-reactive protein(hs CRP),D-Dimer(D-D)and fibrinogen(FIB)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and lung function and prognosis.Methods:88 patients with AECOPD who were diagnosed and treated in our hospital from August 2017 to August 2019 were selected as the observation group,and the patients were further divided into 85 survival group and 3 death group according to the survival conditions of the patients.Meanwhile,50 healthy subjects who underwent physical examination in our hospital during the same period were selected as the health group.Serum PCT,hs-CRP,D-D and FIB levels of patients in each group were detected.Pulmonary function indicators including Forced expiratory volume in the first second(FEV1)%,ratio of forced expiratory volume to forced vital capacity in the first second(FEV1/FVC)and Maximum ventilation volume(MVV)were detected by pulmonary function detector,and pearson correlation analysis was used for correlation analysis of all indicators.Results:Compared with the control group,the levels of PCT,hs-CRP,D-D and FIB in the observation group were significantly higher(P<0.05).Compared with the survival group,the levels of PCT,hs-CRP,D-D and FIB in the dead group were significantly higher(P<0.05),FEV1%,FEV1/FVC and MVV were significantly lower(P<0.05).Pearson correlation analysis showed that serum PCT,hs-CRP,D-D and FIB levels were negatively correlated with FEV1%,FEV1/FVC and MVV lung function indexes(P<0.05).Conclusion:The decline of pulmonary function and poor prognosis in patients with AECOPD are closely related to the increase of serum PCT,hs-CRP,D-D and FIB levels,which have certain clinical value in the prognosis prediction of patients with AECOPD.

关 键 词：慢性阻塞性肺疾病 急性加重期 降钙素原 超敏C反应蛋白 D-二聚体 纤维蛋白原 肺功能 预后 

分 类 号：R563[医药卫生—呼吸系统]