C-反应蛋白在慢性阻塞性肺疾病中的应用价值

目的：测定C-反应蛋白（CRP）在慢性阻塞性肺疾病患者（COPD）不同分期中静脉血数值的变化，了解其在本病的价值。方法104例入组病例平行分为COPD急性加重期（AECOPD）组、COPD稳定期（S-COPD）组和健康对照组，分别检测3组患者静脉血CRP，对各组数据作出统计学分析；对AECOPD组治疗前、后CRP结果作出受试者工作曲线（ROC曲线）。结果 CRP在AECOPD组治疗前明显高于治疗后和其他两组，差异有统计学意义（P ＜0．005）；AECOPD组治疗后CRP较S-COPD组未见明显差异（P＞0．05）；S-COPD组CRP明显高于健康体检组（P ＜0．005）；根据ROC曲线，选择CRP＞14．6 mg/L为停用抗菌药物界值，敏感性和特异性分别为91％和93％，ROC曲线下面积（AUC）为0．892。结论 CRP在COPD患者不同分期存在显著变化，可以作为AECOPD患者停用抗菌药物的检测指标之一。

Value and application of C-reactive protein in chronic obstructive pulmonary disease

Objective To inspect the level of C-reactive protein in patients with different stages of chronic obstructive pulmonary disease（COPD）,and to appraise the value in the disease.Methods A total of 104 patients were divided into acute exacerbation of chronic obstructive pulmonary disease （AECOPD）group,stable period of chronic obstructive pulmonary disease（S-COPD）group and normal controls group.The C-reactive protein in serum of all patients was inspected in parallel,and receiver operating characteristic （ROC）curve was ob-tained by analyzing the AECOPD group data of the statistics.Results CRP before treatment in AECOPD group was significantly higher than that post treatment and other two groups,and the difference was statistically significant（P〈0.001）;CRP of post treatment in AECOPD group was not significantly higher than that of S-COPD group（P〉0.05）;CRP of S-COPD group was significantly higher than that of normal controls group（P〈0.001）;according to ROC curve,the cutoff point was CRP〉14.6mg/l to stop using of antibiotics,the sensitivity and specificity were 91%and 93%,and AUC was 0.892.Conclusion CRP in different stages of COPD has significant change,which can be used as one of detection index to stop using antibiotics in AECOPD patients.