慢性阻塞性肺疾病急性加重期血清C-反应蛋白测定的临床意义

目的 探讨C-反应蛋白（CRP）在慢性阻塞性肺疾病急性加重期（AECOPD）患者治疗中的意义。方法对比80例AECOPD患者入院前后血清CRP水平、白细胞总数（WBC）、肺功能（FEV1％预计值）和动脉血气分析动态变化情况。结果AECOPD患者血清CRP水平显著高于COPD稳定期患者（P〈0．01）,治疗后CRP在WBC未显著变化时已明显下降,治疗前后的差异有统计学意义（P〈0．01）。CRP的阳性率明显高于白细胞计数、中性粒细胞比率、血沉、体温。结论CRP升高不仅提示COPD的急性加重,极度升高提示COPD患者病情严重并且可能预后不良。CRP作为反映细菌性感染的敏感指标,在疗效上比WBC更迅速、敏感。

Clinical singniticance of CRP in hosopital patients with acute exacerbations of chronic obstructive pulmonary disease

Objective To study the clinical significance of CRP in acute exacerbations of hospitalized patients with chronic obstructive pulmonary disease （COPD） before and after treatment. Methods The serum CRP levels, the improvement of pulmonary function （FEV1% ） and the gross of white blood cell （WBC） were detected of 80 inpatients with acute exacerbations of COPD before and after 1 weeks treatment. Results Before treatment, the levels of serum CRP were significantly higher than those of normal subjects（ P 〈 0.01 ）. At the same time, the CRP difference between before and after the use of antibiotics was also significant （P 〈 0.01 ）. The positive rate of CRP was higher than that of WBC, so were the positive rate of neutrophil, ESR and body temperature. Conclusion El- evated serum CRP is a predictor of exacerbation in patients with COPD, and extremely high level of CRP may be the indicator of severe condition with poor prognosis. CRP is a good marker in acute exacerbation period with COPD. CRP is a sensitive and specific index to the acute phase of COPD, can express immediate effectiveness of antibiotic selected, and is more sensitive and quickier compared with WBC.