COPD患者外周血淋巴细胞计数及血清CRP PCT变化与疾病严重程度的关系  

Changes of Peripheral Blood Absolute Lymphocyte Count Serum CRP and PCT in Patients with COPD and Their Relationship with Disease Severity

作　　者：康恒 李迅[1] 文华 薛本洁 KANG Heng;LI Xun;WEN Hua(Chuzhou Hospital,Anhui Medical University/Chuzhou First People's Hospital,Anhui Chuzhou 239000,China)

机构地区：[1]安徽医科大学附属滁州医院/滁州市第一人民医院呼吸与危重症医学科,安徽滁州239000 [2]滁州城市职业学院医学系,安徽滁州239000

出　　处：《河北医学》2023年第8期1287-1292,共6页Hebei Medicine

基　　金：2022年度安徽省中医药传承创新科研项目,(编号:2022CCZD06)。

摘　　要：目的:分析慢性阻塞性肺疾病(COPD)患者外周血淋巴细胞计数(absolute lymphocyte count,ALC)及血清C反应蛋白(CRP)、降钙素原(PCT)变化与疾病严重程度的关系。方法:选取2019年1月至2022年2月期间入院治疗的COPD患者102例,根据患者疾病进展和肺功能严重程度,分为COPD稳定期组和COPD急性加重期(AECOPD)组、Ⅰ级~Ⅳ级组,另取同期体检健康者100例作对照组。检测并比较各组ALC、CRP和PCT水平差异,分析上述指标与肺功能指标[第1秒用力呼吸容积(FEV1)占预计值百分比(FEV1%预计值)]的相关性,并观察AECOPD患者治疗前后ALC、CRP和PCT水平的变化。结果:COPD组外周血ALC明显低于对照组,CRP和PCT水平明显高于对照组(P<0.05);AECOPD组外周血ALC明显低于COPD稳定期组,CRP和PCT水平明显高于COPD稳定期组(P<0.05);不同肺功能严重程度患者外周血ALC、CRP和PCT水平比较,差异有统计学意义(P<0.05);进一步两两比较,ALC水平Ⅳ级低于Ⅰ级、Ⅱ级,CRP和PCT水平Ⅳ级>Ⅲ级>Ⅱ级>Ⅰ级(P<0.05);COPD患者外周血ALC水平与FEV1%预计值呈正相关,CRP和PCT与FEV1%预计值呈负相关(P<0.05);与治疗前比较,治疗后AECOPD患者外周血ALC水平明显升高,CRP和PCT水平明显降低(P<0.05)。结论:COPD患者外周血ALC、CRP和PCT水平与疾病严重程度密切相关,还可指导AECOPD治疗。Objective:To analyze the changes of peripheral blood absolute lymphocyte count(ALC),serum C-reactive protein(CRP)and procalcitonin(PCT),and their relationship with disease severity in patients with chronic obstructive pulmonary disease(COPD).Methods:A total of 102 patients with COPD treated in the hospital were enrolled between January 2019 and February 2022.According to disease progression and the severity of pulmonary function,they were divided into stable COPD group and acute exacerbation of COPD(AECOPD)group,and grades I-IV groups.A total of 100 healthy controls were enrolled as control group.The differences in levels of ALC,CRP and PCT in different groups were detected and compared,and the correlation between the above indexes and pulmonary function index[forced expiratory volume in 1 second(FEV1)as a percentage of predicted value(FEV1%)]was analyzed.The changes of ALC,CRP and PCT before and after treatment were observed.Results:The peripheral blood ALC was significantly lower in COPD group than control group,while levels of CRP and PCT were significantly higher in COPD group(P<0.05).The peripheral blood ALC was significantly lower in AECOPD group than stable COPD group,while levels of CRP and PCT were significantly higher in AECOPD group(P<0.05).The differences in levels of ALC,CRP and PCT among patients with different severity of pulmonary function were statistically significant(P<0.05).Further pairwise comparison showed that ALC level in patients at grade IV was lower than that at grades I and II,while CRP and PCT levels were the highest in patients at grade IV,followed by grade III,grade II and grade I(P<0.05).The level of peripheral blood ALC was positively correlated with FEV1%,while CRP and PCT were negatively correlated with it(P<0.05).After treatment,ALC was significantly increased,while levels of CRP and PCT were significantly decreased(P<0.05).Conclusion:The levels of peripheral blood ALC,serum CRP and PCT are closely related to disease severity in COPD patients,which can also guide the treatment

关 键 词：慢性阻塞性肺疾病 淋巴细胞计数 C反应蛋白 降钙素原 疾病严重程度 

分 类 号：R563.9[医药卫生—呼吸系统]