老年慢性阻塞性肺疾病合并下呼吸道细菌感染者 FeNO、PCT水平与肺功能及CAT评分的关联  

Relationship between FeNO,PCT and pulmonary function,CAT score in elderly patients with chronic obstructive pulmonary disease and lower respiratory tract bacterial infection

作　　者：张莉 王书香 王玲玲 靳楠楠 豆银霞 ZHANG Li;WANG Shu-xiang;WANG Ling-ing;JIN Nan-nan;DOU Yin-xia(Zhengzhou Shuqing Medical College,Zhengzhou,Henan 450052,China;不详)

机构地区：[1]郑州澍青医学高等专科学校护理系,河南郑州450052 [2]郑州市第九人民医院老年医学中心一病区,河南郑州450053

出　　处：《中华医院感染学杂志》2023年第15期2261-2265,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学教育研究项目(Wjlx2021146)。

摘　　要：目的 探究老年慢性阻塞性肺疾病(COPD)合并下呼吸道细菌感染者呼出气一氧化氮(FeNO)、降钙素原(PCT)水平与肺功能及慢性阻塞性肺病评估测试(CAT)评分的关联。方法 选择2020年7月-2022年7月在郑州市第九人民医院确诊的92例COPD合并下呼吸道细菌感染的患者为本研究对象,分离鉴定病原菌,呼气分析仪检测FeNO,化学发光法检测血清PCT。采用肺功能检测仪检测第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%pred)和用力肺活量(FVC),计算FEV1%值,慢性阻塞性肺疾病全球倡议(GOLD)分级评估患者气流受限严重程度。采用COPD患者自我评估测试问卷(CAT)多维度评估患者病情严重程度。采用Pearson相关性分析FeNO、PCT与CAT评分的关系,Spearman相关性分析FeNO、PCT与肺功能的关系。结果 92例COPD合并下呼吸道细菌感染患者共分离病原菌95株,主要为流感嗜血杆菌、肺炎链球菌和肺炎克雷伯菌;痊愈时,所有COPD合并下呼吸道感染患者FeNO、PCT、CAT评分均较入院时下降,肺功能GOLD分级为4级的人数减少,GOLD分级为2级的人数增多,患者FEV1和FEV1/FVC值升高(P<0.05);COPD合并下呼吸道感染患者FeNO、PCT水平与GOLD分级和CAT评分均呈正相关(P<0.05)。结论 COPD合并下呼吸道感染患者FeNO、PCT水平与肺功能GOLD分级和CAT评分均呈正相关,FeNO、PCT水平越高表示患者肺功能水平越低,病情越严重。OBJECTIVE To explore the relationship between fraction exhaled nitric oxide(FeNO),procalcitonin(PCT)and pulmonary function,scores of COPD Assessment Test(CAT)in elderly patients with chronic obstructive pulmonary disease(COPD)and lower respiratory tract bacterial infection.METHODS A total of 92 patients with COPD and lower respiratory tract bacterial infection confirmed in Zhengzhou 9th People's Hospital between Jul 2020 and Jul 2022 were enrolled as the research objects.Pathogens were isolated and identified.FeNO was detected by exhalation analyzer,and serum PCT was detected by chemiluminescence method.The forced expiratory volume in 1 second(FEV1),FEV1 as a percentage of the predicted value(FEV1%pred)and forced vital capacity(FVC)were detected by spirometer.FEV1%was calculated and the severity of airflow limitation was evaluated by global initiative forchronic obstructive lung disease grading.The disease severity was multidimensionally evaluated by CAT.The relationship between FeNO,PCT and CAT score was analyzed by Pearson correlation analysis.The relationship between FeNO,PCT and pulmonary function was analyzed by Spearman correlation analysis.RESULTS In the 92 patients with COPD and lower respiratory tract bacterial infection,there were 95 strains of pathogens,mainly including Haemophilus influenzae,Streptococcus pneumoniae and Klebsiella pneumoniae.Compared with those at admission,FeNO,PCT and CAT scores were significantly decreased after recovery;number of cases with pulmonary function GOLD grading at grade 4 was significantly reduced;number of cases at grade 2 was significantly increased;FEV1 and FEV1/FVC were significantly increased(P<0.05).The levels of FeNO and PCT were positively correlated with GOLD grading and CAT score(P<0.05).CONCLUSION In patients with COPD and lower respiratory tract infection,levels of FeNO and PCT are positively correlated with GOLD grading and CAT scores.The higher levels of FeNO and PCT show the lower level of pulmonary function and the more severe of the disease.

关 键 词：慢性阻塞性肺疾病 下呼吸道细菌感染 呼出气一氧化氮 降钙素原 肺功能 肺功能及慢性阻塞性肺病评估测试评分 

分 类 号：R563[医药卫生—呼吸系统]