降钙素原、BODE指数联合诱导痰中性粒细胞计数在慢性阻塞性肺疾病人群中的研究

Study on Procalcitonin and BODE Index Combined With Induced Sputum Neutrophil Count in Patients With Chronic Obstructive Pulmonary Disease

目的研究慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重期治疗前及治疗后血清降钙素原(PCT)及BODE指数以及诱导痰中性粒细胞计数(induced neutrophils,IN)的改变,判断PCT、BODE指数、IN与COPD患者细菌感染程度的关联性,指导COPD患者抗菌药物药物的治疗。方法选取2018年12月—2019年12月期间,在潍坊市第二人民医院的呼吸与危重症医学科治疗的AECOPD患者80例为研究对象,同时取社会健康志愿者20例为研究对照。进行血PCT、IN、肺通气功能、体质指数(BMI)、改良英国医学研究委员会呼吸困难指数(MMRC)测定、6分钟步行试验(6MWD),测算出BODE指数,进行研究分析。结果COPD患者急性加重期与缓解期比较,COPD患者缓解期的血清降钙素原、BODE指数及IN均较急性加重期有明显好转,差异有统计学意义(P<0.05)。结论AECOPD患者,血清降钙素原、BODE指数及IN明显升高,抗菌药物治疗后,患者症状缓解,血清降钙素原、BODE指数及IN水平下降。COPD患者的血清降钙素原、BODE指数及IN之间存在相关性,同时与COPD患者细菌感染的程度分级也存在相关性,检测COPD患者血清降钙素原、BODE指数及IN对于判断AECOPD患者感染的严重程度有重大指导价值,减少抗菌药物使用,指导临床工作。

Objective To study the changes of serum procalcitonin(PCT),BODE index and induced sputum neutrophil count(induced neutrophils,IN)before and after treatment in acute exacerbation of chronic obstructive pulmonary disease(COPD),To determine the relationship between PCT,BODE index,IN and the degree of bacterial infection in COPD patients,to guide the treatment of COPD patients with antibiotics.Methods From December 2018 to December 2019,80 AECOPD patients treated in the Department of Respiratory and Critical Care Medicine of Weifang Second People’s Hospital were selected as the research objects,and 20 healthy volunteers were selected as the research control.Blood PCT,IN,pulmonary ventilation function,body mass index(BMI),modified British Medical Research Council dyspnea index(MMRC),6-minute walk test(6MWD)were measured,and BODE index was calculated and analyzed.Results Compared with the acute exacerbation period of COPD patients and the remission period,the serum procalcitonin,BODE index and IN of the COPD patients in the remission period were significantly improved compared with the acute exacerbation period,and the difference was statistically significant(P<0.05).Conclusion In patients with AECOPD,serum procalcitonin,BODE index and IN were significantly increased.After antibiotic treatment,the patient’s symptoms were relieved,and serum procalcitonin,BODE index and IN levels decreased.There is a correlation between serum procalcitonin,BODE index and IN in COPD patients,and there is also a correlation with the degree of bacterial infection in COPD patients.Detection of serum procalcitonin,BODE index and IN in COPD patients is helpful for judging AECOPD patients.The severity of infection has significant guiding value to reduce the use of antimicrobials and guide clinical work.