慢性阻塞性肺病急性加重期降钙素原水平与预后关系探讨

目的探讨慢性阻塞性肺病急性加重期降钙素原水平与预后关系。方法选取2009年1月-2012年12月在本院呼吸科住院的慢性阻塞性肺病患者102例作为观察组研究对象，依据患者病情分为急性加重期组（A组）60例和稳定期组（B组）42例；另选取我院普通肺炎患者99例作为对照组，采集所有患者血液，进行PCT、血白细胞（WBC）、C反应蛋白（CRP）、血氧饱和度（S02％）水平的检测，常规留取痰液做痰培养培养；患者出院后随访2年进行评估，记录患者呼吸困难指数（mMRC）、病情发作频率及最终转归。结果观察组与对照组患者PCT、WBC、S02比较，差异有统计学意义（P〈0．05）。急性加重期患者与稳定期患者PCT、WBC、CRP及S02比较均有统计学差异（P〈0．05），急性加重期与稳定期患者mMRC、2年内发作频率与入院次数间比较，差异有统计学意义（P〈0．05）。急性加重期患者痰培养率及2年内死亡率明显高于稳定期患者，差异有统计学意义（P〈0．05）。结论对于感染诱发的COPD急性加重期患者，检测PCT水平可以反映患者的病情及预后。

Study on relationship between procalcitonin level and prognosis on acute exacerbation of chronic obstructive pulmonary disease

Objective To study the relationship between procalcitonin level and prognosis on acute exacerbation of chronic obstructive pulmonary disease. Methods 102 cases with chronic obstructive pulmonary disease from January 2009 to December 2012 in the respiratory department of the author hospitalwere chosen as observation group,based on the patient＇s condition who were divided into 60 cases of group A（acute exacerbation group）and 42 patientsof group B（stable group）; another 99 cases of ordinary pneumonia in our hospital were selected as a control group. The blood was collected for all patients to detect the levels of PCT, white blood cells （WBC）, C-reactive protein（CRP）,oxygen saturation（SO2%）,Routine sputum specimens cultured sputum culture;the patients were followed up in 2years after discharge to assess dyspnea index patient records（mMRC）,disease seizure frequency and final outcome. Results The difference was statistically significant in PCT,WBC,SO2 between the observation group and control group （P 〈 0.05）.The difference was statistically significant in PCT,WBC,CRP,SO2 andmMRC,seizure frequency and number of admissions in 2 years of patients between at acute exacerbation and stable （P 〈 0.05）. The sputum culture rate and death rate in 2 yearsofpatients at acute exacerbation were significantly higher than at stable, the difference was statistically significant （P 〈 0.05）. Conclusion For chronic obstructive pulmonary infections in patients with acute exacerbation of which led to a major incentive in terms of exacerbations of lung disease,PCT levels of detection may reflect the level of the patient＇s condition and prognosis.