C反应蛋白在AECOPD的意义

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）变化的意义及临床应用价值。方法检测152例AECOPD患者及88名COPD缓解期患者CRP、白细胞计数（WBC）、中性粒细胞计数百分比（N）、血沉（ESR），疾培养及X线胸片，同时对152例AECOPD患者给予抗感染治疗，并比较这些指标治疗前后的变化。结果AECOPD患者血清CRP水平显著高于COPD稳定期患者（P〈0．01），而在AECOPD患者死亡组血清CRP水平又显著高于存活组（P〈0．001）。结论CRP升高不仅可以提示COPD的急性加重，极度升高又提示COPD患者病情严重并且可能预后不良。CRP在AECOPD是一个良好的观察指标，可反映抗生素的即时疗效，比WBC，ESR更迅速且敏感。

Clinical value of CRP in acute exacerbation period patients with COPD

Objective To investigate the serum level of c-reactive protein （CRP） in the patients with chronic obstructive pulmonary disease （COPD） , including stable COPD and acute exacerbation of COPD （AECOPD）. Methods 152 AECOPD patients and 88 stable COPD patients were selected CRP, WBC, ESR were detected. Chest x-ray was taken. The 152 AECOPD patients were treated with effective antibiotics, and were compared in the changes of these markers. Results The serum CRP levels in the AECOPD patients were significantly higher than that in the stable COPD patients （P 〈0. 01 ）. The serum CRP levels in the dead AECOPD patients were significantly higher than that in the alive AECOPD patients （ P 〈 0. 001 ）. Conclusion Elevated serum CRP is a predictor of exacerbation in the COPD patients. An 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. It can express immediate effectiveness of antibiotic selected, and is more sensitive and quickier, compared with WBC, ESR.