C-反应蛋白、降钙素原以及D-二聚体在AECOPD中联合监测的意义

A Study of Combined Detection of C-reactive Protein,Procalcitonin and D-dimer Level Associated with AECOPD

目的分析C-反应蛋白、降钙素原以及D-二聚体在慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)中联合监测的意义。方法研究选取本院就诊的确诊慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者106例进行研究,其中COPD稳定期患者56例,AECOPD患者50例。收集患者静脉血并检测降钙素(procalcitonin,PCT)、C-反应蛋白(C-Reactive protein,CRP)、D-二聚体(D-Dimer,D-D)等指标水平并进行比较,AECOPD组患者在入院后2h、治疗后7d以及出院前对三指标水平动态变化进行分析讨论。数据均应用SPSS17.0统计软件包进行分析。结果本研究中,入院时AECOPD组患者PCT水平为0.93±0.24ng/m L,COPD组为0.43±0.07ng/m L,AECOPD组显著升高,P<0.05;入院时AECOPD组患者CRP水平为24.87±3.76g/L,COPD组为14.07±3.94g/L,也表现为AECOPD组显著升高,P<0.05;D-D水平也可见类似结果,AECOPD组患者为1523.76±235.65μg/L,COPD组为987.87±209.76μg/L,AECOPD组显著升高,P<0.05。对AECOPD组患者入院时、入院后7d和出院时三个时间点的监测数据分析可见随着治疗干预的进行及患者病情缓解出院,PCT、CRP及D-D水平在AECOPD患者中均呈逐渐减低趋势,三个指标在三个不同时间点的监测数据差别均有统计学意义,P<0.05。结论 PCT、CRP及D-D水平联合监测对于判定COPD患者预后以及评价AECOPD患者病情及治疗效果具有积极的预测意义,值得临床关注并应用于相关预防与治疗工作中。

Objective To analyze the significance of co-monitoring of c-reactive protein, procalcitonin and d-dimer in AECOPD. Methods A total of 106 patients with COPD were enrolled in this study. 56 patients with COPD and 50 patients with AECOPD were enrolled in this study. The levels of PCT, CRP, D-D and other indicators were collected and compared. The levels of indexes were analyzed at three time points： Admission level, level for 7 days after treatment and discharge level. Data were analyzed using SPSS 17.0 statistical software package. Results In the present study, the level of PCT in the AECOPD group was （0.93 ± 0.24） ng / mL, in the COPD group was （0.43 ± 0.07） ng / mL. The AECOPD group was significantly higher （P 〈0.05） . The CRP level of admission was （24.87 ± 3.76） g / L in the AECOPD group, while （14.07 ±3.94） g / L in the COPD group, so significantly higher in the AECOPD group （P 〈0.05）. The level of DD in the AECOPD group was （1523.76 ± 235.65） μg / L, COPD group （987.87 ± 209.76） μg / L, so AECOPD group was significantly higher（P〈0.05）. The levels of PCT, CRP and DD were significantly decreased for AECOPD patients after the treatment （P 〈0.05）. The differences of monitoring data between the three indexes at three different time points were statistically significant （P 〈0.05）. Conclusion The combined monitoring of PCT, CRP and D-D can be used to predict the prognosis of patients with COPD and evaluate the condition and treatment effect of AECOPD patients. It is worthy of clinical attention and can be used in related prevention and treatment.