CRP、PCT、WBC、Neu%及ESR对慢性阻塞性肺疾病急性加重期细菌感染的诊断价值

Diagnostic value of CRP,PCT,WBC,Neu% and ESR on bacterial infection in acute exacerbation of chronic obstructive pulmonary disease

目的探讨血清中C反应蛋白(C-reactiveprotein,CRP)、降钙素原(procalcitio Ilin,PCT)、白细胞总数(leukocyte count,WBC)、中性粒细胞百分比(neutrophilic granulocyte,Neu%)及血沉(erythrocyte sedimentation rate,ESR)水平在慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)细菌感染患者中的临床价值。方法选取2015年1月~2017年6月间于我院呼吸科诊治的AECOPD患者36例,其中感染组20例,非感染组16例,检测治疗前后血清中CRP、PCT、WBC、Neu%及ESR水平,分析其与AECOPD细菌感染的关系。结果感染组与非感染组AECOPD患者治疗前CRP、PCT、WBC、Neu%水平组间差异有统计学意义(P<0.05),ESR水平组间无差异(P>0.05);感染组患者治疗前后CRP、PCT、WBC水平差异有统计学意义(P<0.05),而Neu%和ESR水平差异无统计学意义(P>0.05);AECOPD患者治疗前后CRP、PCT、WBC、Neu%及ESR水平差异有统计学意义(P<0.05)。结论 CRP、PCT、WBC、Neu%及ESR联合检测是判断AECOPD患者是否合并细菌感染的有效指标,同时也为AECOPD患者的治疗和预后评估提供了临床指导。

Objective To investigate the clinical value of levels of serum C-reactive protein（CRP）, procalcitiorium （PCT）, leukocyte count（WBC）, neutrophilic granulocyte（Neu%） and erythrocyte sedimentation rate（ESR） in the patients with bacterial infection of acute exacerbations of chronic obstructive pulmonary disease（AECOPD）. Methods 36 AE- COPD patients who were diagnosed and treated in the department of respiratory medicine in our hospital from January 2015 to June 2017 were selected. Among them, 20 cases were in infection group, and 16 cases were in non-infection group. The levels of serum CRP, PCT, WBC, Neu% and ESR were measured before and after treatment, and its rela- tionship with AECOPD bacterial infection was analyzed. Results The levels of CRP, PCT, WBC and Neu% in AECOPD patients before and after treatment were statistically significantly different between the infection group and non-infec- tion group（P〈0.05）. There was no difference in ESR level between two groups（P〉0.05）; there were statistically significant difference in levels of CRP, PCT and WBC before and after treatment in infection group（P〈0.05）, and there was no sta- tistically significant difference in levels of Neu% and ESR between two groups（P〉O.05）; there was statistically signifi- cant difference in levels of CRP, PCT, WBC, Neu% and ESR before and after treatment in AECOPD patients（P〈0.05）. Conclusion The combined detection of CRP, PCT, WBC, Neu% and ESR is an effective index for judging the bacterial infection in patients with AECOPD. It also provides clinical guidance for the treatment and prognosis evaluation of pa- tients with AECOPD.