血清降钙素原水平分级在慢性阻塞性肺疾病急性加重期的临床价值探讨

目的:探讨血清降钙素原(Procalcitonin,PCT)水平分级在慢性阻塞性肺疾病急性加重期(Acute exacerbation ofchronic obstructive pulmonary disease,AECOPD)的临床价值。方法:以48例进入本研究的慢性阻塞性肺疾病急性加重期患者作为病例组,另随机抽取同期住院的45例普通肺炎患者作为对照组。两组均于24h内测定血清PCT、血常规、C反应蛋白(C-reactiveprotein,CRP)及进行痰培养,同时将病例组按PCT水平分为<0.05、0.05～1.0、1.0～10、10～20、≥20ng.ml-1五个等级,并分析各组的抗生素使用时间、住院时间、痰培养阳性、好转及死亡。结果:病例组血清PCT明显高于对照组,且有统计学意义(P<0.05),而两组WBC计数、CRP均无统计学意义(P>0.05)。随着血清PCT水平的逐渐升高,病例组好转率逐渐下降,抗生素使用时间与需住院时间也延长,痰培养阳性、病死率均呈逐渐上升的趋势(P<0.05)。结论:血清PCT水平分级对慢性阻塞性肺疾病急性加重期的病情诊断、评估预后有指导意义。

Investigation of the clinical value of different serum procalcitonin levels in acute exacerbation of chronic obstructive pulmonary disease

Objective: To explore the clinical value of different serum procalcitonin levels in acute exacerbation of chronic obstructive pulmonary disease.Methods: Serum PCT levels,white blood cell count,C reactive protein(CRP) concentrations and sputum culture were determined within 24 hours after diagnosis in 48 patients with acute exacerbation of chronic obstructive pulmonary disease(case group) and 45 patients with common pneumonia(control group).Moreover,patients with acute exacerbation of chronic obstructive pulmonary disease were divided into five groups depending on different levels of serum PCT:<0.05 ng·ml-1 group,0.05~1.0 ng·ml-1 group,1.0~10 ng·ml-1 group,10~20 ng·ml-1 group and≥20 ng·ml-1 group.The length of using antibiotics,the hospital stay,the sputum culture positive,recovery and mortality were analyzed.Results: The levels of serum PCT in case group were obviously higher than those in contro1 group(P<0.05),but no significant difference in white blood cell count and CRP between the two groups(P>0.05).With increasing PCT levels,the recovery rate decreased gradually;the morbidity,the sputum culture positive rate,the length of using antibiotics and hospital stay increased markedly(P< 0.05).Conclusion: Different serum PCT levels has clinical value in diagnosis and assessment of prognosis of acute exacerbation of chronic obstructive pulmonary disease.