前降钙素与C-反应蛋白测定对有创及无创机械通气的慢性阻塞性肺疾病患者感染程度诊断价值

目的探讨前降钙素(PCT)及C-反应蛋白(CRP)联合测定在有创与无创机械通气的慢性阻塞性肺病(COPD)患者感染程度评价中的价值。方法应用双抗夹心免疫发光法测定血浆PCT含量,散射比浊法测定血浆CRP水平,对32例有创机械通气的COPD患者、30例无创机械通气的COPD患者、25名健康志愿者分别进行血浆PCT和CRP水平的测定。所有患者入院后24 h行急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ评分)测定。结果有创组A-PACHEⅡ评分高于无创组,差异有统计学意义(P<0.05)。对照组PCT和CRP值分别为(0.42±0.19)ng/ml和(1.10±0.30)mg/L,有创机械通气组PCT和CRP值分别为(6.25±4.16)ng/ml和(46.86±18.59)mg/L;无创机械通气组PCT和CRP值分别为(3.35±2.12)ng/ml和(41.29±16.30)mg/L;均较对照组明显升高(P<0.01),有创机械通气组PCT水平明显高于无创通气组,差异有统计学意义(P<0.05),CRP值比较,有创机械通气组高于无创通气组,但差异无统计学意义(P﹥0.05)。结论 PCT及CRP联合测定可以预测有创与无创械通气COPD患者感染程度。

Diagnostic value of procalcitonin combined with C-reactive protein on infectious degree of COPD patients with NIPPV and IPPV

Objective To inaestigate the diagnostic value of procalcitonin（PCT） combined with C-reactive protein（CRP） on infectious degree evaluation of COPD patients with noninvasive positive mechanical ventilation（NIPPV） and invasive positive me- chanical ventilation（IPPV）. Methods Plasma PCT was detected by immunoluminometrie assay（ILMA） and CRP was measured by nephelemetry. The plasma PCT and CRP levels of 32 cases of COPD with IPPV, 30 cases of COPD with NIPPV and 25 healthy volunteers were detected. The acute physiology and chronic health evaluation （APACHE） Ⅱ score was calculated during the first 24 h of ICU admission. Results The APACHE Ⅱ score in NIPPV group was higher than that in IPPV group, and there was significant defferenee （ P 〈 0.05）. The serum levels of PCT and CRP in IPPV and NIPPV group were （6.25 ±4.16）ng/ml and （46.86±18.59） mg/L, （3.35±2.12） ng/ml and （41.29±16.30） rag/L, which were much higher than those in the control group （0.42±0.19） ng/ml and （ 1.10±0.30） mg/L ] （ P 〈 0. 01 ）. The serum level of PCT in IPPV group was much higher than that in the NIPPV group, and there was significant difference （P 〈 0.05 ）. There was no significant difference in the serum level of CRP between IPPV group and NIPPV group （ P 〉 0.05 ）. Conclusion Combined detection of serum PCT and CRP lev- els ean predict the infectious degree in the COPD patients with NIPPV and IPPV.