降钙素原测定在危重支气管哮喘急性发作患者中的意义及其影响因素

The significance of procalcitonin detection in severe bronchial asthma acute exacerbations patients and its influence factors

目的研究支气管哮喘急性发作期患者血清降钙素原（procalcitonin，PCT）测定的意义及影响因素。方法将收治的60例支气管哮喘急性发作期患者纳入研究对象．按照降钙素原含量分为观察组32例和对照组28例，观察组患者血清PCT≥1．5ng／mL，对照组患者血清PCT〈1．5ng／mL，检测两组患者的肺功能指标、血清炎症因子含量、抗生素使用时间和机械通气比例，Logistic回归及Pearson相关性分析影响PCT水平的因素及相关性。结果观察组患者PEF、FEV1／FVC、6MWD和MMRC均低于对照组（P〈0．05），血清TNF-α、IL-8和IL-1β水平均高于对照组（P〈0．05）；观察组和对照组患者抗生素时间分别为中位数10（0～15）、5（0～10），机械通气比例为25．00％、10．71％。Logistic回归分析显示肺功能状态及炎症指标是PCT水平的影响因素，且PEF、FEV1／FVC、6MWD和MMRC与PCT含量呈负相关（P〈0．05），血清TNF-α、IL-8和IL-1β水平与PCT呈正相关（P〈0．05）。结论支气管哮喘急性发作期患者的PCT水平能评估感染的严重程度及疾病预后，其水平受患者肺功能状态和全身感染情况影响。

Objective To study the significance of procalcitonin detection in bronchial asthma acute exacerbations patients and its influence factors. Methods 60 cases patients with bronchial asthma acute exacerbations in our hospital were enrolled and divided into two groups according to calcitonin levels. The serum PCT level in observation group was ≥ 1.5 ng/mL, while the serum PCT level in control group was〈1.5 ng/mL. Then pulmonary function index and serum inflammatory factors contents were detected. The duration of antibiotic treatment and the rates of mechanical ventilation were observed. Logistic regression analysis and Pearson correlation analysis were applied to evaluate the risk factors for PCT level and the correlation of PCT with pulmonary function and inflammatory factors contents. Results The PEF, FEV1/FVC, 6 MWD and MMRC in the observation group were lower than those in the control group （P〈0.05）, and the levels of serum TNF-α, IL-8 and IL-113 were higher than those of the control group（P〈0.05）; The duration of antibiotic therapy and the rates of mechanical ventilation was respectively 10 （0-15）days and 25.00% in observation group, and 5（0-10）days and 10.71% in control group（P〈0.05）. Logistic regression analysis showed that pulmonary function and inflammatory factors contents were risk factors for the level of PCT, PEF, FEV1/FVC, 6 MWD and MMRC were negatively correlated with PCT levels（P〈0.05）, serum TNF-α, IL-8 and IL-1β levels were positively correlated with PCT levels （P〈0.05）. Conclusion The level of PCT in patients with acute exacerbation of bronchial asthma can be used to assess the severity of infection and the prognosis of the disease.