联合检测血清PCT、CRP在细菌感染引起AECOPD患者的诊断价值

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目的探讨检测血清降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)水平对指导细菌感染引起慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者临床诊治中的意义。方法对AECOPD患者58例(A组)及COPD稳定期患者31例(B组),采用免疫发光法测定其血清PCT及CRP水平,并进行诱导痰细菌定量培养;以痰中下呼吸道潜在病原菌(PPM)浓度107CFU/mL作为诊断AECOPD细菌感染的标准,将AECOPD患者分为有细菌感染组(A1组35例)、无细菌感染组(A2组23例)。结果 AECOPD有细菌感染组血清PCT(0.22±0.03)ng/mL,CRP(59.79±10.23)mg/mL水平高于无细菌感染组PCT(0.11±0.02)ng/mL,CRP(18.34±3.15)mg/mL及稳定期组PCT(0.08±0.01)ng/mL,CRP(10.06±1.63)mg/mL,差异有统计学意义(P<0.05)。COPD急性加重期无细菌感染组PCT(0.11±0.02)ng/mL水平高于稳定期组PCT(0.08±0.01)ng/mL,差异无统计学意义(P>0.05),急性加重期无细菌感染组CRP(18.34±3.15)mg/mL水平高于CRP(10.06±1.63)mg/mL,差异有统计学意义(P<0.05)。结论 COPD患者PCT水平升高可能与细菌感染有关、而CRP水平升高可能提示急性加重,联合检测血清PCT及CRP可以帮助了解AECOPD的细菌感染及指导抗生素应用。 Objective To investigate the effects of serum levels of procalcitonin (PCT) and C-reactive protein (CRP) on the pathogenesis of chronic exacerbation of chronic obstructive pulmonary disease (AECOPD) ) Clinical significance of the patient. Methods Fifty-eight patients with AECOPD (group A) and 31 patients with stable COPD (group B) were enrolled in this study. The levels of serum PCT and CRP were measured by immunoluminescence assay and the sputum bacterial culture was induced. The potential pathogenic bacteria PPM) was used as the standard to diagnose AECOPD bacterial infection. AECOPD patients were divided into bacterial infection group (A1 group, 35 cases) and no bacterial infection group (A2 group, 23 cases). Results The levels of PCT (0.22 ± 0.03) ng / mL and CRP (59.79 ± 10.23) mg / mL in patients with bacterial infection were significantly higher than those without bacterial infection (0.11 ± 0.02 ng / mL, CRP, 18.34 ± 3.15 mg (P <0.05). The difference was statistically significant (P <0.05). The difference was statistically significant (P <0.05). The level of PCT (0.11 ± 0.02) ng / mL in patients with acute exacerbation without COPD was significantly higher than that in the stable patients (0.08 ± 0.01) ng / mL, with no significant difference (P> 0.05). There was no bacterial infection in acute exacerbation The level of CRP (18.34 ± 3.15) mg / mL was higher than that of CRP (10.06 ± 1.63) mg / mL, the difference was statistically significant (P <0.05). Conclusions The elevated PCT levels in patients with COPD may be related to bacterial infection. However, the elevated CRP levels may indicate acute exacerbations. Combined detection of serum PCT and CRP may help to understand the bacterial infection of AECOPD and guide the application of antibiotics.
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