和肽素、PCT、CRP和NLR检测对慢性阻塞性肺疾病伴呼吸衰竭患者的诊断价值

Diagnostic value of copeptin,PCT,CRP and NLR in COPD patients with respiratory failure

目的探讨和肽素、降钙素原(PCT)、C反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)检测对慢性阻塞性肺疾病(COPD)伴呼吸衰竭患者的诊断价值。方法选取2016年12月至2018年11月该院收治的COPD患者88例,其中单纯COPD(COPD组)26例,COPD伴呼吸衰竭(呼吸衰竭组)62例。比较COPD组和呼吸衰竭组患者血清和肽素、PCT、CRP水平及NLR;采用受试者工作特征曲线(ROC曲线)分析各指标对COPD患者发生呼吸衰竭的诊断价值。结果呼吸衰竭组患者的和肽素、PCT、CRP水平及NLR均明显高于COPD组,差异有统计学意义(P<0.05)。ROC曲线分析显示,和肽素、NLR对COPD伴呼吸衰竭的诊断效能较高,和肽素诊断COPD伴呼吸衰竭的曲线下面积为0.886,灵敏度为98.4%,特异度为79.2%;NLR诊断COPD伴呼吸衰竭的曲线下面积为0.810,灵敏度为86.9%,特异度为66.7%。结论血清和肽素、NLR对COPD患者发生呼吸衰竭具有良好的诊断价值。

Objective To investigate the diagnostic value of copeptin,procalcitonin(PCT),C-reactive protein(CRP),and neutrophil to lymphocyte ratio(NLR)in chronic obstructive pulmonary disease(COPD)patients with respiratory failure.Methods A total of 88 patients with COPD admitted to the hospital from December 2016 to November 2018 were selected,including 26 patients with COPD(COPD group)and 62 patients with COPD accompanied by respiratory failure(respiratory failure group).Serum copeptin,PCT,CRP and NLR of patients in COPD group and respiratory failure group were compared.ROC curve was used to analyse the diagnostic value of each index in COPD patients with respivatory failure.Results The levels of copeptin,PCT,CRP and NLR in patients with respiratory failure were significantly higher than those in COPD group,and the differences were statistically significant(P<0.05).The ROC curve analysis showed that the area under the curve,sensitivity and specificity of copeptin were 0.886,98.4% and 79.2%,the area under the curve,sensitivity and specificity of NLR were 0.810,86.9% and 66.7%.Conclusion Copeptin and NLR have good diagnostic value in monitoring the respiratory failure in COPD patients.