慢性阻塞性肺疾病急性加重期患者血清PCT、CRP动态变化及回归分析

目的探讨慢性阻塞性肺疾病急性加重期患者(AECOPD)血清降钙素原(Procalcitonin,PCT)和C反应蛋白(c-reactive protein,CRP)的动态变化,并分析其临床意义。方法选择我院收治的82例AECOPD患者,在入院第1、3、5、7、9天抽取静脉血,动态检测所有患者的血清CRP及PCT水平,并对结果取对数(LN)后进行线性回归分析。同时根据是否合并肺炎,进行多元线性回归的亚组分析。结果患者LN(PCT)的值与时间相关,有统计学意义(P值0.05),并得到回归方程:LN(PCT)=2.37-0.46 day。同时LN(CRP)的值与时间相关,有统计学意义(P值0.05),并得到回归方程:LN(CRP)=5.01-0.30day。方程代入正常值可知,AECOPD患者PCT恢复至正常值较CRP恢复至正常值早3.11天。同时对是否合并肺炎进行亚组分析,统计得出LN(PCT)及LN(CRP)的数值分别与天数(day)以及合并肺炎与否(pneu)两个变量相关(P0.05)。PCT的方程为:LN(PCT)=1.91-0.46day+0.68pneu,CRP的方程为:LN(CRP)=4.66-0.30day+0.53pneu。将正常值带入方程可知合并肺炎组(A组)比不合并肺炎组(B组)患者PCT指标恢复到正常值早1.48天,CRP指标恢复到正常值早1.77天。结论合并肺炎的AECOPD患者,血清PCT、CRP恢复时间更长。同时,血清PCT在AECOPD患者的恢复过程中,较CRP更为灵敏,动态监测PCT能有助于确定抗生素的停药时间,减少抗生素的滥用。

Dynamic changes and regression analysis of serum PCT and CRP in patients with AECOPD

Objective To explore the dynamic changes of serum procalcitonin (PCT)and C-reactive protein (CRP)in patients with AECOPD,and to analyze its clinical significance.Methods 82 AECOPD patients were se-lected from our hospital,all of whom were taken for venous blood on 1st,3rd,5th,7th and 9th days after admission. Their serum CRP and PCT were dynamically detected.Linear regression analysis was performed on logarithm (LN)of the results.At the same time,subgroup analysis of multiple linear regression was carried out according to whether ac-companied with pneumonia.Results Patient’s LN (PCT)was associated with time (day)(P <0.05),and the re-gression equation was:LN (PCT)=2.37 -0.46 day.At the same time,LN (CRP)was also associated with time (day)(P <0.05,and the regression equation was:LN (CRP)=5.01 -0.30 day.The normal values were substi-tuted into the equations,and it was obtained that the time for PCT back to normal value in AECOPD patients was 3.11 days earlier than that of CRP.Subgroup analysis showed that LN (PCT)and LN (CRP)were associated with the variables-time (day)and whether accompanied with pneumonia (pneu),respectively (P <0.05).The equation of PCT was:LN (PCT)=1.91 -0.46 day +0.68 pneu,while the equation of CRP was:LN (CRP)=4.66 -0.30 day +0.53 pneu.The normal values were substituted into the equations,and it was obtained that the time for PCT back to normal value in the group A (accompanied with pneumonia)was 1.48 days earlier than that of the group B (not accompanied with pneumonia).Conclusion For AECOPD patients combined with pneumonia,the recovery time of serum PCT and CRP is longer.At the same time,serum PCT in the recovery process of AECOPD patients is more sensitive than CRP.Dynamic monitoring of PCT can help to determine the withdrawal time of antibiotic drug and reduce the abuse of antibiotics.