PCT和NT-ProBNP在AECOPD病情评估中的临床研究

The clinical study of PCT and NT-ProBNP in AECOPD illness condition assessment

目的：探讨降钙素原（PCT）和N末端B型脑利钠肽前体（NT-ProBNP）在慢性阻塞性肺疾病急性加重（AECOPD）患者病情评估和治疗效果中的临床意义。方法：选择2014年1月至2016年1月我院ICU收治的50例AECOPD患者作为研究对象，分别检测所有患者入院时和治疗后的PCT与NT—ProBNP水平，同时进行急性生理与慢性健康状况Ⅱ（APACHEⅡ）系统评分。对比分析AECOPD患者入院时和治疗后PcT、NT-ProBNP和APACHEII评分的相关性及患者治疗前后PCT、NT-ProBNP和APACHEII评分的差异。结果：入院时患者PCT和NT—ProBNP与APACHEII评分呈正相关（r值分别为0．6057和0．4433，P〈0．05），治疗后患者PCT、NT—ProBNP和APACHEII评分较治疗前明显下降，差异有统计学意义（P〈0．05）。治疗后患者PCT和NT-ProBNP与APACHEII评分仍呈正相关（r值分别为0．4150和0．4099，P〈0．05）。结论：AECOPD患者PCT和NT—ProBNP与APACHEII评分具有良好的相关性，PCT与NT—ProBNP可作为AECOPD患者病情严重程度和治疗效果的评价指标。

Objective： To explore clinical significance of procalcitonin （PCT） and N-terminal pro-B-type natriuretic peptide （NT-ProBNP） in the evaluation of condition and therapeutic effect of patients with acute exacerbation chronic obstructive pulmonary disease （AECOPD） . Methods： 50 cases of patients with AECOPD in the department of ICU in our hospital from January 2014 to January 2016 were selected for the study. Then levels of PCT and NT-ProBNP were detected and APACHE Ⅱ were scored , which were compared before and after treatment. Meanwhile, correlations analysis were made of PCT, NT-ProBNP levels and APACHE Ⅱ scores before and after treatment. Results： PCT and NT-ProBNP levels were positively correlated to APACHE Ⅱ scores （r=0.6057 and 0.4433, P〈0.05） in patients with AECOPD before treatment. However, PCT, NT-ProBNP levels and APACHE Ⅱ scores were significantly decreased after treatment compared with those before treatment （P〈0.05） . Besides, PCT and NT-ProBNP levels were still obviously correlated to APACHEⅡ scores （r=0.415（1 and 0.4099, P〈0.05） after treatment. Conclusion： There are quite good correlations between PCT, NT-ProBNP levels and APACHE Ⅱ scores, which can be used as objective indicators of the severity and treatment effect in patients with AECOPD.