急性加重期慢性阻塞性肺疾病患者血降钙素原水平变化及其与肺功能的相关性研究

Changes of serum procalcitonin level in patients with acute exacerbation of chronic obstructive pulmonary disease and its correlation with pulmonary function

目的分析急性加重期慢性阻塞性肺疾病(AECOPD)患者血降钙素原(PCT)水平变化及其与肺功能的相关性。方法根据纳入和排除标准,筛选出2015年8月到2017年3月90例符合条件的AECOPD患者作为研究对象,筛选同期50例健康志愿者和60例稳定期COPD患者作为对照,以上受试对象均来自阳泉市第一人民医院的体检或就诊患者,对比三组患者血清PCT水平和肺功能指标。将急性加重组根据肺功能等级分为三组,观察三组患者随着肺功能变化、血清PCT水平变化情况。最后将90例患者血清PCT水平与一秒用力呼气容积(FEV1)、一秒用力呼气容积占预计值百分比(FEV1%)和FEV1/用力肺活量(FVC)进行Pearson相关性分析。结果两组慢性阻塞性肺疾病组血清PCT水平均高于健康组(P<0.05),急性加重期血清PCT水平高于稳定期患者(P<0.05)。两组慢性阻塞性肺疾病组肺功能均有一定程度下降,与健康组比较,FEV1、FEV1%和FEV1/FVC值均明显下降(P<0.05),急性加重期组肺功能较稳定期患者更加恶化(P<0.05)。在急性加重组中,随着肺功能的恶化,血清PCT水平随之增加(P<0.05)。急性加重组患者血清PCT水平分别和FEV1、FEV1%、FEV1/FVC值呈负相关关系(P<0.05)。结论AECOPD患者血清PCT会明显增高,且随着肺功能恶化呈现增加趋势。

Objective To analyze the changes of serum procalcitonin(PCT)level and its correlation with pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Ninety patients with AECOPD from August 2015 to March 2017 were enrolled in the study according to inclusion and exclusion criteria.Meanwhile,50 healthy volunteers with physical examination and 60 stable chronic obstructive pulmonary disease(COPD)patients were selected as controls.The above subjects were selected from the patients who received physcial examination or consultation in the First People's Hospital of Yangquan.The serum PCT levels and lung function indexes of the three groups were compared.Patients in AECOPD group were grouped according to grades of lung function,and the changes of serum PCT level with the changes of pulmonary function in the three groups were observed.Finally,the serum PCT levels of 90 patients were analyzed by Pearson correlation with forced expiratory volume in one second(FEV1),forced expiratory volume in one second to forced vital capacity ratio(FEV1%)and FEV1/forced vital capacity(FVC).Results The serum PCT levels in the stable COPD group and AECOPD group were significantly higher than those in the healthy group(P<0.05).The level of serum PCT in the acute exacerbation stage was higher than that in the stable stage(P<0.05).The lung function of stable COPD group and AECOPD group decreased to some extent.Compared with the healthy group,FEV1 and FEV1%and FEV1/FVC value decreased significantly in stable COPD group and AECOPD group(P<0.05).The lung function of the AECOPD group was worse than stable COPD group(P<0.05).The serum levels of PCT increased with lung function deterioration in the AECOPD group(P<0.05).The serum PCT levels in patients with AECOPD were negatively correlated with FEV1,FEV1%and FEV1/FVC value(P<0.05).Conclusions The serum PCT in patients with AECOPD increases significantly,and shows an increasing trend with the deterioration of pulmonary function.