支气管扩张合并感染患者血清降钙素原、C-反应蛋白和25-羟维生素D_(3)变化及其临床检测价值研究  

Changes of serum procalcitonin,C-reactive protein and 25-hydroxyvitamin D_(3)levels in patients with bronchiectasis combined with infection and their clinical value

作　　者：梁建峰 程玉峰 LIANG Jianfeng;CHENG Yufeng(Department of Pulmonary Disease,Bozhou Hospital of Traditional Chinese Medicine,Bozhou 236800,China)

机构地区：[1]亳州市中医院肺病科,安徽亳州236800

出　　处：《陕西医学杂志》2024年第5期688-691,共4页Shaanxi Medical Journal

基　　金：安徽省中医药传承创新科研项目(2022CCYB07)。

摘　　要：目的:探讨支气管扩张合并感染患者血清降钙素原(PCT)、C-反应蛋白(CRP)以及25-羟维生素D_(3)[25-(OH)D_(3)]变化及临床检测价值。方法:选取支气管扩张合并感染患者49例为感染组,根据临床肺部感染评分(CPIS)将患者分为轻度组(18例)、中度组(19例)和重度组(12例)。另选择同期体检健康者50例为健康对照组。比较感染组和健康对照组以及不同感染严重程度患者血清PCT、CRP及25-(OH)D_(3)水平。采用Spearman法分析血清25-(OH)D_(3)、PCT、CRP与支气管扩张患者感染严重程度的相关性。绘制受试者工作特征曲线(ROC)分析血清PCT、CRP及25-(OH)D_(3)对支气管扩张合并重度感染的诊断价值。结果:感染组PCT、CRP水平高于健康对照组,25-(OH)D_(3)水平低于健康对照组(均P<0.05)。随着感染程度加重,PCT、CRP水平逐渐升高,25-(OH)D_(3)水平逐渐降低(均P<0.05)。血清PCT、CRP水平与患者感染严重程度呈正相关(均P<0.05)。血清25-(OH)D_(3)水平与患者感染严重程度呈负相关(P<0.05)。三项指标联合诊断支气管扩张合并重度感染的曲线下面积(AUC)高于单独PCT、CRP及25-(OH)D_(3)的AUC(均P<0.05)。结论:支气管扩张合并感染患者血清PCT和CRP水平升高,25-(OH)D_(3)水平降低,且与感染严重程度有关,三者联合对支气管扩张合并重度感染诊断价值较高。Objective:To investigate the changes of serum procalcitonin(PCT),C-reactive protein(CRP)and 25-hydroxyvitamin D_(3)(25-[OH]D_(3))levels in patients with bronchiectasis combined with infection and their clinical value.Methods:A total of 49 patients with bronchiectasis combined with infection were selected as the infection group.According to the clinical pulmonary infection score(CPIS),the infection group was divided into a mild group(18 cases),a moderate group(19 cases)and a severe group(12 cases).Another 50 healthy subjects were selected as healthy control group.The levels of serum PCT,CRP and 25-(OH)D_(3)were compared between the infected group and the healthy control group and the patients with different infection severity.Spearman method was used to analyze the correlation between serum 25-(OH)D_(3),PCT,CRP and the severity of infection in patients with bronchiectasis.The receiver operating characteristic curve(ROC)was drawn to analyze the diagnostic value of serum PCT,CRP and 25-(OH)D_(3)in bronchiectasis combined with severe infection.Results:The PCT and CRP levels in infected group were higher than those in healthy control group,and the 25-(OH)D_(3)level was lower than that in healthy control group(all P<0.05).With the aggravating degree of infection,the levels of PCT and CRP gradually increased,while the level of 25-(OH)D_(3)gradually decreased(all P<0.05).Serum PCT and CRP levels were positively correlated with the severity of infection(all P<0.05).Serum 25-(OH)D_(3)level was negatively correlated with infection severity(P<0.05).The area under the curve(AUC)for the combined diagnosis of bronchiectasis combined with severe infection was higher than that of PCT,CRP and 25-(OH)D_(3)alone(all P<0.05).Conclusion:Serum PCT and CRP levels are increased and 25-(OH)D_(3)level is decreased in patients with bronchiectasis combined with infection,which are related to the severity of infection.The combination of the three have higher diagnostic value in patients with bronchiectasis combined with severe infection.

关 键 词：支气管扩张 感染 25-羟维生素D_(3) 降钙素原 C-反应蛋白 诊断价值 

分 类 号：R562.2[医药卫生—呼吸系统]