血清炎性标志物在慢性阻塞性肺疾病急性加重期诊断中的价值

Value of serum inflammatory markers in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease

目的探讨联合检测血清炎性标志物降钙素原、白细胞介素-6、白细胞介素-8对慢性阻塞性肺疾病急性加重期细菌感染的诊断价值.方法将102例慢性阻塞性肺疾病急性加重期患者依据痰液中潜在病原菌浓度分为感染组52例和非感染组50例,选取同期20名健康志愿者设为对照组.检测比较3组治疗前后血清降钙素原、白细胞介素-6、白细胞介素-8水平.结果治疗前3组血清降钙素原、白细胞介素-6、白细胞介素-8水平比较差异有统计学意义(P<0.01),其中感染组血清降钙素原、白细胞介素-6、白细胞介素-8水平均显著高于非感染组和对照组(P<0.05或0.01),非感染组血清降钙素原、白细胞介素-6、白细胞介素-8水平与对照组比较差异无统计学意义(P>0.05);治疗后感染组血清降钙素原、白细胞介素-6、白细胞介素-8水平较治疗前显著下降(P<0.05),与对照组比较差异均无统计学意义(P>0.05).非感染组入组时血清降钙素原阳性检出10例(20.0%),白细胞介素-6、白细胞介素-8任意一项阳性检出17例(34.0%);感染组治疗前血清降钙素原阳性检出36例(69.2%),白细胞介素-6、白细胞介素-8任意一项阳性检出46例(88.5%).血清降钙素原阳性检出灵敏度为45.1%(46/102),白细胞介素-6、白细胞介素-8任意一项阳性检出灵敏度为61.8%(53/102).结论联合检测血清炎性标志物降钙素原、白细胞介素-6与白细胞介素-8水平有助于临床准确判断慢性阻塞性肺疾病急性加重期患者细菌感染状况,为合理应用抗生素提供科学依据.

Objective To explore the diagnostic value of serum PCT.IL-6 and IL-8 in bacterial infection from patients with acute exacerbation of chronic obstructive pulmonary disease.Methods 102 patients with acute exacerbation of chronic obstructive pulmonary disease were divided into infected group(52 cases)and non-infected group(50 cases)according to the concentration of potential pathogens in sputum.20 healthy volunteers were selected as the control group.Detect and compare the PCT,IL-6 and IL-8 expression levels in the three groups before and after trea tment.Results Before treatment,there was a statistically significant difference in serum PCT,IL-6,and IL-8 levels among the three groups(P<0.01).The levels of PCT,IL-6,and IL-8 in the inected group were significantly higher than those in the non-infected group and the control group(P<0.05 or 0.01).The levels of serum PCT,IL-6,and IL-8 in the non-infected group were not significantly different from those in the control group(P>0.05).After treatment,the levels of serum PCT,IL-6,and IL-8 in the infection group were significantly lower than before treatment(P<0.05),and there was no significant difference compared with the control group(P>0.05).In the non-infected group,10 cases were positive for PCT(20.0%),and 17 cases were positive for any of IL-6 and IL-8(34.0%).In the infection group,36 cases(69.2%)were positive for PCT,and 46 cases were positive for any of IL-6 and IL-8(88.5%).The sensitivity of PCT positive detection was 45.1%(46/102),and the sensitivity of IL-6,IL-8 positive detection was 61.8%(53/102).Conclusions Combined detection of serum inflammatory markers PCT,IL-6,and IL-8 expression levels can help clinically accurately determine the bacterial infection status of patients with AECOPD,and provide scientific basis for the rational application of antibiotics in patients with AECOPD.