哮喘-慢性阻塞性肺疾病重叠综合征急性加重期血清PCT、总IgE检测的意义

Significance of detection of serum PCT and total IgE in patients with acute exacerbation of asthma-chronic obstructive pulmonary disease overlap syndrome

目的探讨哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)急性加重期患者血清降钙素原(PCT)、总IgE(T-IgE)的表达及临床意义。方法连续收集44例ACOS急性加重期患者作为ACOS组,51例单纯慢性阻塞性肺疾病(COPD)急性加重期COPD(AECOPD)患者作为AECOPD组,47例单纯支气管哮喘急性发作患者作为哮喘组,所有入组病例均检测血清PCT、T-IgE。结果 ACOS、AECOPD两组血清PCT水平明显高于哮喘组,差异有统计学意义(P<0.05),但ACOS、AECOPD两组PCT水平差异无统计学意义(P>0.05);ACOS、哮喘两组T-IgE水平明显高于AECOPD组,差异有统计学意义(P<0.05),但是ACOS、哮喘组两组TIgE水平差异无统计学意义(P>0.05);以PCT≥0.25ng/mL为临界值,PCT和T-IgE在3组中的阳性率分别为75.00%、78.41%、19.15%和65.91%、9.80%、78.72%;ACOS组患者PCT和T-IgE均阳性为40.91%。结论血清PCT、T-IgE用于鉴别3组疾病的价值较低,但是PCT和T-IgE同时增高可考虑为ACOS的辅助诊断依据;ACOS急性发作可能存在不同发病表型。

Objective To investigate the expression and clinical significance of serum procalcitonin（PCT）and total IgE（T-IgE）in patients with acute exacerbation of asthma-chronic obstructive pulmonary disease overlap syndrome（ACOS）.Methods A total of 44 patients with acute exacerbation of ACOS,51 patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）,47 patients with acute attack of bronchial asthma were enrolled in the study,and all the cases were examined for serum PCT and T-IgE.Results The levels of PCT in the two groups of ACOS and AECOPD were significantly higher than that in the asthma group,the differences were statistically significant（P〈0.05）,but there was no statistical significance in PCT levels between ACOS group and AECOPD group（P〉0.05）;the levels of T-IgE in ACOS group and asthma group were significantly higher than that in AECOPD group,the differences were statistically significant（P〈0.05）,but there was no statistical significance in T-IgE levels between ACOS group and asthma group（P〉0.05）.With PCT≥0.25 ng/mL as critical value,the positive rates of PCT and T-IgE in 3 groups were 75.00%,78.41%,19.15% and 65.91%,9.80%,78.72%respectively,and the positive rates of PCT and T-IgE in ACOS group were both 40.91%.Conclusion The value of serum PCT and T-IgE in identifying the diseases in three groups are low,but the increase of PCT and T-IgE at the same time may be considered as the auxiliary diagnostic basis of ACOS.There may be different phenotypes in ACOS acute attack.