慢性阻塞性肺病急性加重期C反应蛋白测定的临床价值

目的:探讨慢性阻塞性肺病(COPD)急性加重期C反应蛋白(CRP)测定的临床价值。方法:选择在2年观察期内因COPD急性加重而收住院的患者84例,记录其入院时的临床症状,并测定肺功能及血清CRP水平,分析CRP水平与Anthonisen症状评分及第1秒用力呼气量占预计值百分比的相关性。结果:COPD急性加重期患者血清CRP平均值(17.26±9.31)mg/L,显著高于健康对照组。Anthonisen症状评分1分组血清CRP水平低于2分和3分组,2分组又低于3分组(P均<0.05)。FEV1占预计值80%以上的患者CRP水平显著低于其他患者(P<0.01)。FEV1占预计值百分比小于80%的患者中,随着气流受限程度的加重,CRP水平逐渐增高,但差异无统计学意义(P均>0.05)。COPD急性加重期患者血清CRP水平与Anthonisen症状评分及气流受限程度均呈正相关(r分别为0.409和0.506,均P<0.001)。结论:COPD急性加重期患者血清CRP显著升高,CRP水平与症状的严重程度和气流受限的严重程度均呈正相关,血清CRP水平可能反映COPD急性加重期患者疾病的严重程度。

Value of C-reactive Protein Measurement in Hospitalized Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Objective: To explore the value of C-reactive protein(CRP) measurement in hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease(COPD).Methods: Eighty-four patients who were hospitalized with acute exacerbations of COPD were enrolled in two years' observational period.The Anthonisen symptoms score was recorded and spirometry was conducted.Serum CRP was measured at the initial of hospitalization.The associations between serum CRP and Anthonisen score or FEV_(1)percent of predictive were analyzed.Results: Serum CRP level in patients with acute exacerbations of COPD was significantly higher than healthy controls(17.26±9.31)mg/L versus(2.46±1.07) mg/L,P<0.005].Serum CRP level in patients with Anthonisen score 1 was significantly lower than those with Anthonisen score 2 or 3(both P<0.05),and those with Anthonisen score 2 lower than those with Anthonisen score 3(P<(0.05).) Patients whose FEV_(1) were above 80% of predictive had lower serum CRP level than those whose FEV_1 less than 80% of predictive(P<0.01).Serum CRP level increased with the increasing degree of airflow limitation but was not statistically significant.Serum CRP level was correlated positively with Anthonisen score and the degree of airflow limitation(r=0.409,0.506 respectively,both P<0.01).Conclusion: Serum CRP level in patients with acute exacerbations of COPD increased significantly and was correlated with Anthonisen score and the degree of airflow limitation.Serum CRP level might reflect the severity of acute exacerbations of COPD.