C反应蛋白及降钙素原检测在老年有机磷中毒并肺部感染患者中的应用价值

Application value of C reactive protein and calcitonin detection in elderly patients with organic phosphorus poisoning complicated with pulmonary infection

目的探讨C反应蛋白(CRP)、降钙素原(PCT)、白细胞(WBC)和中性粒细胞(N%)以及血气分析结果在有机磷中毒(AOPP)合并肺部感染老年患者中的临床应用价值。方法采用回顾性病例对照研究收集2006年6月至2012年8月我院AOPP且均完善胸部影像学检查的老年患者60例,其中合并肺部感染者(观察组)30例,未合并肺部感染者(对照组)30例,分别检测2组患者第2天和第3天CRP、PCT、WBC、N%、血气分析结果并比较分析。结果观察组第3天的WBC、N%、PCT、CRP水平高于对照组,差异有统计学意义(P<0.01)。观察组第2天的PCT水平高于对照组,差异有统计学意义(P<0.01)。观察组WBC、N%、CRP第3天的水平高于第2天,差异有统计学意义(P<0.01)。观察组PCT与动脉血二氧化碳分压呈负相关(r=-0.437,P<0.01),与动脉血氧分压呈正相关(r=0.571,P<0.01)。结论老年AOPP合并肺部感染患者在早期相关炎性指标就已升高,检测CRP和PCT等相关炎性指标有利于指导临床用药及评价患者的病情。

Objective To investigate the changes of C reactive protein（ CRP）,calcitonin（ PCT）,blood routine,blood gas analysis in the elderly patients with organ ophosphorus poisoning（ AOPP） and pulmonary infection. Methods A prospective case-control study was conducted,and sixty cases of elderly patients with organic phosphorus poisoning receiving chest X-ray detection in our hospital from June 2006 to August 2012 were recruited. And they were divided into the observation group with pulmonary infection and the control group without pulmonary infection,with 30 cases in each group.The levels of serum CRP,PCT,blood routine and blood gas analysis were detected on the second day and the third day.Results On the third day,the levels of serum CRP,PCT,WBC and N% of the observation group were higher than those of the control group,with statistical significance（ P〈0. 01）. And the level of serum PCT of the observation group was higher than that of the control group on the second day（ P〈0. 01）. The levels of WBC,N% and CRP of the observation group in the third day were higher than that in the second day（ P〈0. 01）. PCT was negatively correlated with arterial partial pressure of carbon dioxide（ r =- 0. 437,P〈0. 01）,and was positively correlated with arterial partial pressure of oxygen（ r = 0. 571,P〈0. 01）. Conclusions The elderly patients with organic phosphorus poisoning complicated with pulmonary infection present with high level of inflammatory indicators in the early stage,and the detection of inflammatory indicators is essential for guiding the clinical medication and evaluating the patient＇s condition.