慢性阻塞性肺疾病急性加重期与稳定期超敏C反应蛋白测定对比研究

目的比较血清中超敏C反应蛋白(hs-CPR)在慢性阻塞性肺疾病(COPD)稳定期与COPD急性加重期(AECOPD)不同。方法选择确诊为AECOPD 45例患者作为观察组,按1∶1比例随机抽取同期门诊COPD稳定期患者45例作为对照组,采肘静脉血1 mL或末梢静脉血20μl,应用免疫散射比浊法测定两组患者血清中hs-CPR的浓度。结果①两组患者性别、吸烟率、年龄、吸烟指数及病程对比差异无统计学意义(P0.05);②两组hs-CRP、白细胞(WBC)及中性粒细胞计数(NC)对比差异均有统计学意义(P0.01),观察组各项指标含量明显高于对照组;③治疗前、治疗后3 d、5 d、7 d观察组hs-CRP浓度逐渐下降,WBC、NC无明显变化;④观察组治疗后7 d与对照组WBC及NC对比差异均有统计学意义(P0.01),而hs-CRP两组对比差异无统计学意义(P0.05)。结论血清中hs-CRP是反映AECOPD患者肺部细菌感染较为敏感的指标,其敏感性明显优于WBC、NC,动态观察hs-CRP的变化可以作为AECOPD感染发生、发展和预后判断的指标,对AECOPD的早期诱因发现、估计肺部感染严重程度和反映抗生素疗效方面具有重要指导意义。

Detection of hs-CRP in COPD patients at acute exacerbation and stable stage

Objective To compare the differences of serum high-sensitivity C reactive protein （ hs-CPR） be-tween COPD patients at stable stage and acute exacerbations. Methods This study selected 45 AECOPD 45 patients as the observation group, and 45 COPD patients at stable stage as the control group. They were collected 1 ml of el-bow vein blood or 20μ L of peripheral venous blood. The application of immune nephelometry was measured in the two groups to detect hs-CPR concentration. Results ① There was significant difference in sex, age, smoking, smoking rate index and duration between the two groups （ P〉0. 05 ） . ② There were significant differences in hs-CRP, white blood cell （WBC） and neutrophil counts （NC） between the two groups （P〈0. 01）, and they were sig-nificantly higher in the observation group than in the control group. ③The concentration of hs-CRP decreased gradu-ally, but WBC and NC had no obvious change after the treatment. ④ The levels of WBC and NC showed statistical differences between the twp groups （P〈0. 01）, and the level of hs-CRP had no significant difference （P〉0. 05）. Conclusion Serum hs-CRP can reflect bacterial infection sensitivity in AECOPD patients, which sensitivity is supe-rior to that of WBC and NC. The dynamic observation of hs-CRP changes can be used as an index to predict its occur-rence, development and prognosis of AECOPD patients.