AECOPD 患者呼出气冷凝液中降钙素原检测及其意义

目的：研究慢性阻塞性肺疾病急性加重期(AECOPD)患者呼出气冷凝液(EBC)中降钙素原(PCT)水平的变化及临床意义。方法选取92例 AECOPD 患者,根据急性生理学与慢性健康状况Ⅱ评分(APACHEⅡ评分)将 AECOPD 患者分为高危组、中危组和低危组,检测入院后24 h内的 EBC 和血清中 PCT、C 反应蛋白(CRP)和白细胞计数(WBC)水平,比较各组间的差异；根据预后将 AECOPD 患者分为存活组与死亡组,比较2组间各指标的差异。同期选取41例正常对照组,检测其 EBC 和血清中 PCT 水平。结果①AECOPD 患者 EBC 和血清中 PCT 水平(0.084±0.043)μg/L,(0.767±0.348)μg/L]高于正常对照组(0.014±0.006)μg/L,(0.041±0.016)μg/L], P <0.01。②EBC 中 PCT 水平在高危组、中危组和低危组3组间的差异有统计学意义(F =20.555, P <0.01)。③死亡组 EBC 和血清中 PCT 水平均高于存活组(t =7.736,P <0.01)。④AECOPD 患者 EBC 中 PCT 水平与血 PCT、血 CRP、WBC 水平和 APACHEⅡ评分均呈正相关(r 分别为0.437、0.399、0.322、0.548,P 值均<0.01)。结论 AECOPD 患者 EBC 中 PCT 水平与患者病情严重程度具有较好的相关性,是判断 AECOPD 严重程度和预后的敏感指标。

The clinical significance of PCT in exhaled breath condensate of patients with AECOPD

Objective To study the changes and clinic significances of procalcitonin (PCT) in exhaled breath condensate (EBC) in patients of acute episode chronic obstructive pulmonary disease (AECOPD).Methods We selected 92 patients with AECOPD,and were divided into three groups, namely high score group,median score group and low score group according to acute physiology and chronic health evaluationⅡ(APACHEⅡ) score.EBC PCT,Serum PCT,C-reactive protein (CRP) and WBC were assayed within the first 24 hours after admission,the differences in those indicators between three groups were analyzed.The patients were divided into survival group and death group according to prognosis,and the differences in those indicators between the two groups were analyzed.We also selected 41 cases of health check-up for the healthy controls,collected their EBC and serum and detected the PCT levels.Results ①The EBC and serum PCT levels in AECOPD group (0.084±0.043)μg/L,(0.767 ± 0.348) μg/L] were higher than control group (0.014 ± 0.006) μg/L,(0.041 ± 0.01 6) μg/L] respectively,P <0.05.②The EBC level of PCT in high score group was higher than that in median score group and that in low score group (F =20.555,P <0.01).③The EBC level of PCT was significantly higher in death group than that in survival group (t =7.736,P <0.01).④The EBC level of PCT had positive relationship with the APACHEⅡ score,serum PCT,CRP and WBC (r =0.437,0.399,0.322, 0.548,all P < 0.01).Conclusions There is a good correlation between the EBC level of PCT and the severity of the disease,suggesting that PCT be a sensitive predictor of severity and prognosis of the AECOPD.