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目的通过测定炎症因子在慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗前后指标的变化情况,探讨早期检测PCT(血清降钙素原)、MMP-9(基质金属蛋白酶-9)、hsCRP(高敏C反应蛋白)对指导临床诊治中的应用意义。方法入选204例(其中健康对照组98例,AECOPD组106例),均记录一般情况并比较治疗前后WBC(白细胞计数)、ESR(血沉)、hsCRP、PCT、MMP-9指标的变化情况。结果两组间年龄、性别、职业、吸烟史及家族史比较差异有统计学意义(P<0.01)。病例组在入院后各炎症因子检测率明显高于对照组,差异有统计学意义(P<0.05)。病例组治疗前后hsCRP、PCT显著下降(P<0.05),且与临床症状一致;MMP-9、WBC及ESR治疗前后差异无统计学意义。结论 hsCRP、PCT、MMP-9作为反映炎症早期指标均参与了COPD的炎症过程,外周血测定hsCRP、PCT在一定程度反映了COPD患者病情演变及严重程度,有益于早期诊断、早期治疗干预。
Objective To investigate the changes of inflammatory cytokines in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) before and after treatment, and to explore the early detection of PCT (serum procalcitonin), MMP-9 (matrix metalloproteinase-9), hsCRP High-sensitivity C-reactive protein) to guide the clinical diagnosis and treatment of the significance. Methods A total of 204 patients (98 in the healthy control group and 106 in the AECOPD group) were enrolled in the study. The changes of WBC, ESR, PCT, MMP-9 were compared before and after treatment. Results There were significant differences in age, sex, occupation, smoking history and family history between the two groups (P <0.01). The incidence of inflammatory cytokines in the case group was significantly higher than that in the control group after admission (P <0.05). The hsCRP and PCT decreased significantly in the case group before and after treatment (P <0.05), and were consistent with the clinical symptoms. There was no significant difference between before and after treatment of MMP-9, WBC and ESR. Conclusion hsCRP, PCT and MMP-9 are involved in the inflammatory process of COPD in early stage of inflammation as well as hsCRP in peripheral blood. PCT reflects the evolution and severity of COPD to a certain extent, which is beneficial to early diagnosis and early treatment intervention.