慢性阻塞性肺病急性加重期C反应蛋白检测的临床意义

The clinical significance of C-reactive proteine in acute exacerbation of chronic obstruction pulmonary disease

目的:研究慢性阻塞性肺病(COPD)患者急性加重期(AECOPD)与缓解期血清C反应蛋白(CRP)水平变化,探讨血清CRP水平对AECOPD患者的诊断意义和临床价值。方法:应用免疫透射比浊法检测43例COPD患者在疾病急性加重期(治疗前)与缓解期(治疗后)的血清CRP水平,同时行血白细胞计数(WBC)、中性粒细胞(N)、红细胞沉降率(ESR)检测及肺功能检查[一秒用力呼出量占预计值百分比(FEV1%)、一秒用力呼出量占肺活量的百分比(FEV1/FVC)]。结果:AECOPD患者CRP阳性率为72.1%,显著高于WBC、N、ESR的阳性发现(P<0.01)。患者急性加重期CRP含量高达(37.61±5.74)mg/L,而缓解期迅速下降至(8.19±3.24)mg/L,较急性加重期显著降低(P<0.01)。AECOPD患者血清CRP与FEV1%、FEV1/FVC的相关性分别为-0.511和-0.644,呈显著负相关,P值均<0.05。结论:AECOPD患者血清CRP水平显著升高,血清CRP检测可作为COPD急性加重的诊断及严重度评估的灵敏指标。

Objective To study the serum C-reactive protein （CRP）level variation in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and stable chronic obstruction pulmonary disease （COPD）, and to investigate its diagnostic value and clinical significance. Methods The serum CRP levels of 43 patients with AECOPD at stable and at exacerbation were measured by turbidimetric immunoassay. The data obtained from examinations of white blood cell （WBC）, neutrophil（N）, erythrosedimentation（ESR）, chest X-ray, forced expiratory volume in ls （FEV1） forced exiratory volume in 1s/forced vital capacity （FEV1/FVC） were also collected. The association between the FEV1 or FEV1/FVC and CRP level were analyzed. Results The positive rates of the serum CRP （72.1%） is significantly higher than the other tests （WBC,N,ESR,X-ray） （P 〈0.01）. The serum CRP levels of COPD patients at exacerbation [（37.61±5.74 mg/L ）were significantly higher than those of the patients at stable （8.19±3.24 mg/L （P〈0.01）, which were significantly correlated negatively with FEV1 and FEV1/FVC （r=-0.511 and -0.644, P〈0.05）. Conclusions The serum CRP level of AECOPD patients increases significantly and it is a sensitive index in diagnosis of AECOPD and assessment of severity.