慢性阻塞性肺疾病合并/未合并支气管扩张患者炎症指标分析

目的通过对高分辨率CT（high resolution CT，HRCT）影像上合并支气管扩张的慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD ）患者与未合并支气管扩张的COPD患者的临床特征及白细胞计数(leukocyte，WBC)、中性粒细胞(neutrophile，N%)、C反应蛋白(C-reactive protein，CRP)、降钙素原(procalcitonin，PCT)等炎症指标的比较，提高对合并支气管扩张的COPD患者临床特征的认识。 方法选取132例COPD 患者，根据胸部HRCT分为A组（合并支气管扩张）47例、B组（不合并支气管扩张）85例，对比分析两组患者的一般情况、动脉血气分析、WBC、N%、CRP、PCT等炎症指标；并比较分析A组内吸烟患者与不吸烟患者之间WBC、N%、CRP、PCT等炎症指标。 结果2组患者一般情况及动脉血气分析差异无统计学意义(P均＞0.05)；A组患者的体质量指数（body mass index，BMI）低于B组，而WBC、N%、CRP、PCT、日常咳脓痰量均明显高于B组，差异均有统计学意义(P均＜0.05)；A组吸烟患者WBC、N%、CRP、PCT均明显高于不吸烟患者，差异有统计学意义(P均＜0.05)。 结论COPD合并支气管扩张患者感染更重，吸烟影响更大，与WBC、CRP、PCT等炎症指标关系密切。PCT及CRP对COPD合并支气管扩张患者的病情判断存在一定诊断价值。

Analysis of the inflammation index in COPD patients with or without-bronchiectasis

ObjectiveTo compare clinical characteristics， leukocyte (WBC)， neutrophile（N%）, C-reactive protein(CRP), procalcitonin(PCT) of chronic obstructive pulmonary disease(COPD) patients with or without bronchiectasis according to High Resolution CT (HRCT) images， and toimprove the understanding of clinical characteristics of COPD patients with bronchiectasis. MethodsA total of 132 COPD patients were selected in this study, and divided into group A(with bronchiectasis) 47 cases and group B (not merge bronchiectasis) 85 cases by the chest HRCT to compare and analyze the general conditions, arterial blood gas analysis, the WBC, N%, CRP and PCT between two groups. Meanwhile, WBC, N%, CRP, PCT and other inflammatory indicators between smoking and non-smoking patients in group A were also compared and analyzed. ResultsThere was no statistically significant difference in general condition and arterial blood gas analysis between two groups(P＞0.05). The body mass index(BMI) of patients in group A was lower than that in group B, while WBC, N%, CRP, PCT and daily cough sputum volume in group A were all significantly higher than that in group B, and the differences between two groups were statistically significant(P＜0.05). Comparison of smoking patients and non-smoking patients in group A showed that WBC, N%, CRP and PCT of smoking patients were significantly higher than those in non-smoking patients, and the difference between two groups was statistically significant(P＜0.05). ConclusionPatients with COPD complicated with bronchiectasis have more serious infection and greater influence of smoking, which is closely related to inflammatory indicators such as WBC, CRP and PCT.PCT and CRP have certain diagnostic value in the diagnosis of COPD patients with bronchiectasis.