C-反应蛋白联合降钙素原对慢性阻塞性肺病急性加重期中细菌感染的诊疗价值

目的：观察慢性阻塞性肺病急性加重期(acute exacerbations of chronic obstructive pulmonary disease，AECOPD) 患者血清中C-反应蛋白(C-reactiveprotein，CRP)和降钙素原(procalcitionin，PCT)的水平变化，探讨CRP联合PCT检测在 AECOPD细菌感染中的诊疗价值。方法：选取湖南师范大学附属湘东医院呼吸科2011年1月至2012年12月间收治的369 例AECOPD患者，对比200例感染患者及169例非感染患者治疗前后血清CRP，PCT，白细胞总数(WBC)，血沉(ESR) 及中性粒细胞百分比(N)指标变化情况，分析CRP及PCT水平变化与AECOPD细菌感染的关系。结果：感染组AEPOD 患者治疗前CRP，PCT，ESR，WBC及N的水平均显著高于非感染组AECOPD患者(P<0.05或P<0.01)，ESR水平差异无 统计学意义(P>0.05)。感染组AECOPD患者CRP，PCT，ESR，WBC及N的水平显著低于治疗前(P<0.05)。治疗后感染 组患者CRP，PCT，WBC及N的水平显著高于非感染组患者(P<0.05)，而ESR水平两组间差异无统计学意义(P>0.05)。 PCT与CRP，ESR，WBC呈正相关(r分别为0.46，0.38，0.20；P<0.05)，与N无关；CRP与WBC，N及ESR呈正相关(r分 别为0.56，0.43，0.30；P<0.05)。结论：CRP联合PCT检测是判断AECOPD患者是否合并细菌感染敏感性较高、特异性 较强的指标，同时也为AECOPD患者的治疗和预后评估提供了临床指导。

Diagnostic value of C-reactive protein and procalcitonin for bacterial infection in acute exacerbations of chronic obstructive pulmonary disease

Objective: To investigate the value of C-reactive protein (CRP) and procalcitonin (PCT) in diagnosis of the bacterial infection in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients by detecting the change of CRP and PCT. Methods: A total of 369 AECOPD patients were divided into infective group and non-infective group. The values of CRP, PCT, WBC, N and ESR were tested and compared before and after treatment in each group. Results: Before treatment, the levels of CRP, PCT, WBC, and N in the infective group were significantly higher than that in the non-infective group (P<0.05 or P<0.01), while there was no significant difference in ESR level between the 2 groups (P>0.05). In the infective group, the levels of CRP, PCT, WBC, N and ESR after the treatment were much lower than those before treatment (P<0.05). After treatment, the levels of CRP, PCT, WBC, and N in the infective group were significantly higher compared with that in the non-infective group (P<0.05), while there was no significant difference of ESR level between the 2 groups (P>0.05). There was a positive relationship between PCT and CRP, ESR and WBC (r=0.46, 0.38, 0.20; P<0.05), CRP and WBC as well as N and ESR (r=0.56, 0.43, 0.30; P<0.05). Conclusion: It is a sensitive method for diagnosis and treatment of the bacterial infection in AECOPD patients through the combination of CRP with PCT and also for evaluation of the prognosis of patients with AECOPD.