慢性阻塞性肺疾病急性加重期患者血清降钙素原和C反应蛋白测定的临床意义

目的 探讨慢性阻塞性肺疾病急性加重期患者血清降钙素原和C反应蛋白测定的临床意义.方法 选取我院2012年4月～2013年12月收治的90例慢性阻塞性肺疾病患者做为研究对象.根据是否需入住ICU分为ICU组30例,非ICU组60例,其中非ICU组再根据入院时痰液颜色将慢性阻塞性肺炎病急性加重期（AECOPD）患者分为脓痰组30例、非脓痰组30例.对比治疗前后三组患者的血清PCT与CRP浓度指标变化情况对预后的影响,浓痰组与非浓痰组抗生素药物的使用情况.结果 ICU组的治疗后血清PCT与CRP浓度水平降幅优于非ICU组,差异具有统计学意义（P＜0.05）.脓痰组患者治疗中抗生素药物使用时间与患者使用人数显著高于非脓痰组,差异具统计学意义（P＜0.05）.结论 AECOPD患者治疗前后联合检测血清PCT、CRT水平,可提高重症感染病例诊断率,指导抗生素的使用及减少患者停药指征.

Clinical significance of measuring serum procalcitonin and C-reactive protein of patients in acute exacerbation period of chronic obstructive pulmonary disease

Objective To investigate the clinical significance of measuring the serum procalcitonin and c-reactive pro- tein of the patients in the acute exacerbation period of chronic obstructive pulmonary disease （AECOPD）. Methods Ninety patients with chronic obstructive pulmonary disease admitted to our department from April 2012 to December 2013 were selected as the study subjects. The patients were assigned to the ICU group （30 patients） and the non-ICU group （60 patients） according to whether they were admitted to ICU or not. Of the non-ICU group, the patients with AECOPD were divided into the purulent sputum group （30 patients） and the non-purulent sputum group （30 patients） according to the color of sputum at admission. The influences of the changes of serum PCT and CRP concentrations on the prognosis of the three groups and the usage of antibiotic drugs of the purulent sputum group and the non-purulent sputum group were compared. Results After treatment, the decreasing degrees of serum PCT and CRP concentration levels of the ICU group were better than those of the non-ICU group, with statistically significant differences （P〈0.05）. The usage time of antibiotic drugs and the number of patients of the purulent sputum group were significantly higher than those of the non-purulent sputum group, with statistically significant differences （P〈0.05）. Conclusion Joint detec- tion of serum PCT and CRT levels before and after treatment for the patients with AECOPD can provide important ref- erence for improving the diagnosis of serious infection cases and guiding the use indications and drug withdrawal indi- cations of antibiotics.