联合检测降钙素原、C反应蛋白在慢性阻塞性肺病急性加重期中的应用-东南大学学报医学版

联合检测降钙素原、C反应蛋白在慢性阻塞性肺病急性加重期中的应用

单位：徐州市中心医院呼吸内科, 江苏徐州 221009

分类号：R563.3

出版年·卷·期（页码）：2018·37·第一期（87-90）

摘要：

目的：探讨检测降钙素原（PCT）、C反应蛋白（CRP）在慢性阻塞性肺病急性加重期（AECOPD）中的意义。方法：收集198例AECOPD患者入院2 h、72 h、1周、出院前的PCT、CRP水平（按入院时PCT水平分为3组，A：PCT<0.10 μg·L^-1；B：PCT为0.10~0.25 μg·L^-1；C：PCT>0.25 μg·L^-1），结合痰、血细菌培养，指导药物选择及评价疗效，对比分析3组患者的临床资料、实验室检查指标及预后。结果：治疗前患者血清PCT、CRP水平可显著升高并多呈协同增高，治疗有效后PCT水平明显下降，3组患者的临床症状、病情程度及实验室检查结果，差异有统计学意义（P<0.05）。A组未予抗菌药物治疗；B组予观察，隔日检测PCT，其中27例PCT>0.25 μg·L^-1，应用抗菌药物治疗后病情好转，35例<0.25 μg·L^-1者未应用抗菌药物；C组予抗菌药物治疗。C组的痰、血培养阳性率明显高于A、B组。结论：AECOPD患者PCT、CRP水平升高提示病情较重，具有良好的灵敏度，可以将PCT、CRP作为选用、更改抗菌药物或评估疗效的参考工具。

Objective: Detecting the values of procalcitonin(PCT) and C-reactive protein(CRP) in chronic obstructive pulmonary disease in acute exacerbation period (AECOPD) diagnosis and treatment. Methods: To collect levels of PCT and CRP of 198 cases in AECOPD patients admitted to hospital within 2 h, 72 h, 1 week after hospitalization and before discharge from hospital. COPD patients had PCT after admission were divided into 3 groups (A: PCT< 0.10 μg·L^-1, B: PCT 0.10~0.25 μg·L^-1, C: PCT> 0.25 μg·L^-1). Combination of phlegm and blood bacterial culture, guide the choice of drugs, evaluate curative effect. The indicators and results of laboratory examinations and prognosis were analyzed comparatively in 3 groups. Results: Before the disease to improve patients' serum PCT, CRP levels almost significantly increased the same time. There was significant difference in medical history, clinical symptom, illness degree and indicators of laboratory examination between 3 groups (P<0.05). Group A, were not given antibacterials. Group B, PCT detected next day, 27 patients with PCT> 0.25 μg·L^-1 using antibacterials and then the diseases were improved, 35 patients with PCT<0.25 μg·L^-1 were not given antibacterials. Group C, antibiotic therapy were given. The results of phlegm and/or blood bacterial culture in group C more than group A and B. Conclusion: AECOPD with high PCT and CRP levels suggest patients have heavier inflammatory response and in serious condition. PCT and CRP with good sensitivity, PCT and CRP levels can be assumed to be selected, changes, or evaluate antibacterial efficacy.

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