C反应蛋白和血沉联合检测对慢性阻塞性肺疾病并发急性感染的预测价值

Clinical prognostic value of combined detection of C reactive protein and erythrocyte sedimentation rate for acute infection in patients with chronic obstructive pulmonary disease

目的:探讨联合检测C反应蛋白(CRP)和血沉(ESR)对慢性阻塞性肺疾病(COPD)患者并发感染的早期预测价值。方法:选取COPD患者50例,其中并发急性感染患者38例,未并发感染者12例,23例健康体检者作为健康对照组。分别检测各组人群静脉血CRP和ESR水平,受试者工作特征曲线(ROC曲线)下面积判断CRP和ESR联合检测预测COPD合并急性感染的诊断价值。结果:COPD无感染组及COPD合并感染组患者血清CRP和ESR的水平显著高于健康对照组(P<0.05);COPD合并感染组CRP和ESR的水平均显著高于COPD无感染组(P<0.05);以CRP为参考指标(截断值=8.2 mg/L)评估COPD感染的敏感性为97.4%,特异性为90.0%,ROC曲线下面积为0.921 1;以ESR为参考指标(截断值=14.1 mm/1 h)评估COPD感染的敏感性为100.0%,特异性为80.0%,ROC曲线下面积为0.914 5。结论:COPD感染患者CRP和ESR显著升高,联合监测CRP和ESR对COPD患者是否并发感染的早期预测有重要临床价值。

Objective To evaluate the clinical prognostic value of combined detection of C-reactive protein （CRP）and erythrocyte sedimentation rate （ESR） for early diagnosis of chronic obstructive pulmonary disease （COPD）with early acute infection . Methods： The levels of CRP and ESR were detected respectively in 50 COPD patients（38 complicated with infection and 12 no complicated infection） and 23 normal adults served as health control. Thediagnostic value of CRP and ESR for COPD complicated with acute infection was assessed by receiver operatingcharacteristic （ROC） curve. Results： Compared with the healthy control group, the levels of CRP and ESR of COPDpatients complicated with or without acute infection were significantly increased （P〈0.05）, and they were muchhigher in COPD patients with acute infection than in COPD patients without acute infection （P〈0.05）. When theserum CRP served as the reference （cut off = 8.2 mg/L）, the diagnosis sensitivity and specificity were 97.4% and90.0% respectively with the area under the ROC curve of 0.921 1, and when the serum ESR as the reference（cut off=14.1mm/1 h）, the diagnosis sensitivity and specificity were 100.0% and 80.0% respectively, with an area under theROC curve of 0.914 5. Conclusions： The levels of CRP and ESR would increase significantly in COPD patientscomplicated with acute infection. Combined detection of CRP and ESR has important clinical value for earlyprediction of acute infection in patients with COPD.