外周血嗜酸性粒细胞计数、触珠蛋白及淀粉样蛋白A、降钙素原在COPD合并肺部感染者的临床诊断价值分析

Clinical diagnostic value of peripheral blood eosinophil count,haptoglobin,amyloid A and procalcitonin in patients with COPD complicated with pulmonary infection

目的:外周血嗜酸性粒细胞(EOS)计数、触珠蛋白(HPT)及淀粉样蛋白A(SAA)、降钙素原(PCT)在慢性阻塞性肺疾病(COPD)合并肺部感染者的临床诊断价值分析。方法:选取我院肺病科2017年4月~2019年4月间收治的COPD患者271例,按照是否感染分为感染组(95例)和未感染组(176例)。分析并比较患者病原分布情况、血生化指标及其对COPD合并肺部感染患者的诊断价值。结果:标本培养共获得132株病原菌,其中革兰氏阴性菌89株,占比67.42%,主要以铜绿假单胞菌、肺炎克雷伯菌为主;革兰氏阳性菌32株,占比24.24%,主要以金黄色普通球菌为主;真菌11株,占比8.33%,主要以白念珠菌为主。感染组患者HPT、SAA、PCT水平均高于未感染组,EOS水平低于未感染组,差异均具有统计学意义。HPT、SAA、PCT、EOS联合诊断COPD合并肺部感染的敏感度和特异度均高于四项指标分别的敏感度和特异度,差异具有统计学意义。结论:COPD合并肺部感染致病菌以革兰氏阴性菌为主,患者HPT、SAA、PCT呈高水平,EOS呈低水平,且联合检测四项指标能进一步提供对COPD合并肺部感染的诊断效能。

Objective To analyze the clinical diagnostic value of peripheral blood eosinophil(EOS)count,haptoglobin(HPT),amyloid A(SAA)and procalcitonin(PCT)in patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection.Methods 271 COPD patients admitted to our hospital between April 2017 and April 2019 were selected and divided into the infected group(95 cases)and the uninfected group(176 cases)according to whether they were infected or not.To analyze and compare the distribution of pathogens,blood biochemical indexes and their diagnostic value for COPD patients complicated with pulmonary infection.Results A total of 132 pathogenic bacteria were obtained from specimen culture,of which 89 strains were Gram-negative bacteria,accounting for 67.42%,mainly Pseudomonas aeruginosa and Klebsiella pneumoniae.32 strains of Gram-positive bacteria,accounting for 24.24%,mainly Staphylococcus aureus.There were 11 fungi,accounting for 8.33%,mainly Candida albicans.The levels of HPT,SAA and PCT in the infected group were higher than those in the uninfected group,and the level of EOS was lower than that in the uninfected group.The sensitivity and specificity of HPT,SAA,PCT and EOS in the joint diagnosis of COPD complicated with pulmonary infection are higher than the sensitivity and specificity of the four indexes respectively,and the difference is statistically significant.Conclusion Gram-negative bacteria are the main pathogens of COPD complicated with pulmonary infection.HPT,SAA,PCT are at a high level and EOS is at a low level.Combined detection of four indicators can further provide diagnostic efficacy for COPD complicated with pulmonary infection.