C-反应蛋白在慢性阻塞性肺疾病急性加重期抗菌治疗中的意义

目的 探讨在慢性阻塞性肺疾病急性加重期（acute exacerbations of chronic obstructive pulmonary disease,AECOPD）,C-反应蛋白（C-reactive protein,CRP）对于抗菌治疗的价值.方法 选择因AECOPD住院的患者364例,入院时测定血清CRP水平,依据CRP是否〉8mg/L,分为CRP阳性组和阴性组.阳性组给予抗菌药物治疗,而阴性组不予抗菌药物;两组均给予吸氧、抗炎、解痉平喘、祛痰等基础治疗.比较治疗前后症状评分、动脉血氧分压（PaO2）、动脉血二氧化碳（PaCO2）、缓解率、总有效率和平均住院天数情况.结果 两组治疗后症状评分、PaO2、PaCO2、缓解率、总有效率、平均住院天数比较,差异均无统计学意义.结论 CRP可作为AECOPD是否有细菌或衣原体、支原体感染的重要指标之一,并指导是否使用抗菌药物.

The significance on C-reactive protein in antimicrobial therapy with acute exacerbations of chronic obstructive pulmonary disease

Objective Discuss the value of C-reactive protein （CRP） in antimicrobial therapy with acute exacerbations of chronic obstructive pulmonary disease （AECOPD）. Methods Selected 364 hospitalized-patients with AECOPD, and determined their CRP levels in serum on admission. The patients with CRP≥8mg/L were divided into the positive group, and others were in the negative group. The positive group was treated with antimicrobial agents, and the negative group was free from antimicrobial a- gents. Both of two groups were given oxygen, anti-inflammatory, anti-spasmodic, anti-asthmatic, expectorant and other basic treatments. Symptom score before and after the treatment, PaO2, PaCO2, response rate, total efficiency rate and hospitalization days were compared. Results All indexes had no statistical difference. Conclusion The level of CRP was an important indicator to infections of bacteria or chlamydia or mycoplasma with AECOPD, and could be used to guide the use of timierobial agents.