慢性阻塞性肺疾病患者血液中PCT、CRP含量变化及临床意义

Changes of PCT and CRP in Blood of Patients with Chronic Obstructive Pulmonary Disease and Its Clinical Significance

目的:探讨慢性阻塞性肺疾病患者在急性期与稳定期以及不同GOLD分级下外周血前降钙素原(PCT)和C反应蛋白(CRP)的变化及临床意义。方法:选取笔者所在医院2015年2月-2017年10月收治的慢性阻塞性肺疾病患者(COPD)132例,其中急性期患者和稳定期患者各66例,同时选取健康志愿者66例,依据病情将上述患者分为急性组、稳定组和健康组各66例,其中急性期患者GOLD分级Ⅰ级、Ⅱ级、Ⅲ级各22例,检测所有患者和志愿者外周血前降钙素原(PCT)和C反应蛋白(CRP),分析比较结果。结果:三组患者PCT和CRP相比差异有统计学意义(P<0.05),其中急性组患者PCT和CRP显著高于稳定组和健康组,差异有统计学意义(P<0.05);稳定组患者PCT和CRP显著高于健康组,差异有统计学意义(P<0.05)。COPD患者不同肺功能分级下PCT和CRP相比差异有统计学意义(P<0.05),其中肺功能Ⅲ级患者PCT和CRP显著高于Ⅰ级和Ⅱ级,差异有统计学意义(P<0.05);肺功能Ⅱ级患者的和CRP显著高于Ⅰ级,差异有统计学意义(P<0.05)。COPD患者外周血PCT和CRP浓度与COPD患者GOLD分级呈正相关(r=0.90、0.80,P<0.05)。结论:外周血中PCT、CRP水平能够很好地反映COPD发病时的严重程度,有助于评估COPD患者的病情和肺功能受损情况,联合检测上述指标有助于协助诊断和治疗。

Objective：To investigate the changes and clinical significance of procalcitonin （PCT） and C-reactive protein （CRP） in peripheral blood of patients with chronic obstructive pulmonary disease （COPD） at acute and stable stages and different GOLD grades.Method：A total of 132 patients with chronic obstructive pulmonary disease （COPD） admitted to our hospital from February 2015 to October 2017 were selected,including 66 patients in acute phase and 66 patients in stable phase,and 66 healthy volunteers were selected.The patients were divided into acute group,stable group and healthy group according to their condition.GOLD grading of patients in acute phase was I.Precalcitonin （PCT） and C-reactive protein （CRP） were detected in peripheral blood of 22 patients and volunteers.Result：The difference of CT and CRP among the three groups was statistically significant （P〈0.05）,the acute group was significantly higher than the stable group and the healthy group, the difference was statistically significant （P〈0.05）,the stable group was significantly higher than the healthy group,the difference was statistically significant （P〈0.05）.PCT and CRP were significantly higher in patients with grade Ⅲ pulmonary function than in patients with grade Ⅰ and Ⅱ pulmonary function （P〈0.05）,CRP and PCT in patients with grade II pulmonary function were significantly higher than that in patients with grade Ipulmonary function （P〈0.05）.There was a positive correlation between the concentration of PCT and CRP in peripheral blood and GOLD classification in COPD patients （r=0.90,0.80,P〈0.05）.Conclusion：The levels of PCT and CRP in peripheral blood can reflect the severity of COPD and help to evaluate the condition of COPD patients and the impairment of pulmonary function.