重症慢性阻塞性肺病急性发作期患者血清PCT,hs-CRP及D-D的表达及意义

Chronic Obstructive Pulmonary Disease: Expression and Significance of Serum PCT, hs-CRP and D-D of Patients in Acute Exacerbation

目的:探究重症慢性阻塞性肺病(COPD)急性发作期患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)和D-二聚体(D-D)的表达及意义。方法:选取2014年9月-2016年9月我院收治的146例COPD患者作为研究对象,其中73例COPD急性发作期(AECOPD)患者纳入急性期组,73例COPD缓解期患者纳入缓解期组,另选取同期来我院体检的40例健康者作为对照组。比较三组研究对象的血清PCT、hs-CRP和D-D水平,同时比较急性期组细菌感染与无细菌感染患者、不同肺功能分级的患者血清PCT、hs-CRP和D-D水平的差异。结果:急性期组与缓解期组患者的血清PCT、hs-CRP和D-D水平较对照组显著升高(P<0.05),急性期组的血清PCT、hs-CRP和D-D水平较缓解期组显著升高,差异有统计学意义(P<0.05)。合并细菌感染组血清PCT、hs-CRP水平均显著高于无细菌感染组(P<0.05),而D-D水平则无统计学差异(P>0.05)。不同肺功能分级患者间的血清PCT、hs-CRP和D-D水平比较差异显著(P<0.05),且肺功能分级越高水平越高(P<0.05)。结论:AECOPD患者的血清PCT、hs-CRP和D-D水平均显著的升高,三者联合检测能够有效反映患者病情严重程度,并有利于诊断患者是否存在有细菌感染。

Objective：To explore the expression and significance of serum procalcitonin （PCT）,high sensitive C reaction protein （hs-CRP） and D-dimer （D-D） in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD）.Methods：A total of 146 patients with COPD,who were treated in First Hospital of Qinhuangdao from September 2014 to September 2016,were selected as research subjects,in which,73 patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） were enrolled in acute stage group,73 patients with remission of chronic obstructive pulmonary disease,in remission group,and 40 healthy persons inspected in the hospital during the same period,control group.The levels of serum PCT,hs-CRP and D-D were compared among the three groups.The levels of serum PCT,hs-CRP and D-D were compared in bacterial infection and non bacterial infection,different pulmonary function grade of the patients with AECOPD.Results：The levels of serum PCT,hs-CRP and D-D in the acute stage group and the remission group were significantly higher than those in the control group （P〈0.05）.The levels of serum PCT,hs-CRP and D-D in the acute stage group were significantly higher than those in the remission group,the differences were statistically significant （P〈0.05）.The levels of serum PCT and hs-CRP in the bacterial infection group were significantly higher than those in the non bacterial infection group （P〈0.05）,there was no significant difference in D-D level （P〉0.05）.The levels of serum PCT,hs-CRP and D-D were significantly different among the patients with different pulmonary function grades （P〈0.05）,the level increased with the increase of pulmonary function grade （P〈0.05）.Conclusion：The levels of serum PCT,hs-CRP and D-D are significantly increased in the patients with AECOPD,and three joint detection can effectively reflect the severity of patients and be helpful for the diagnosis of bacterial infection.