慢性阻塞性肺疾病肺部感染的实验室检测指标分析

Laboratory indicators of lung infection for patients with chronic obstructive pulmonary disease

目的分析白细胞(WBC)、中性粒细胞百分比(NEUT%)和C-反应蛋白(CRP)测定在早期慢性阻塞性肺疾病(COPD)肺部感染诊断的临床使用价值及COPD肺部感染病原菌分布情况。方法选择186例临床诊断为COPD的住院患者为感染组,以60名健康体检者为对照组,比较两组WBC、NEUT%、CRP水平;以痰培养结果分为正常菌群组和有病原菌生长组,按培养出的病原菌分为革兰阳性(G^+)菌组和革兰阴性(G^-)菌组,对各组患者WBC和CRP水平进行统计分析,对这两项指标的灵敏度、特异性、阳性预测值进行比较。对痰培养阳性结果分布进行统计分析。结果感染组患者WBC、NEUT%和CRP水平均高于对照组,差异均有统计学意义(P<0.05)。正常菌群组患者WBC和CRP水平与有病原菌生长组比较差异均无统计学意义(P>0.05)。痰培养阳性中真菌86株,以白假丝酵母最多,占35.85%;细菌73株,G^+菌组患者WBC、NEUT%、CRP水平与G^-菌组比较差异均无统计学意义(P>0.05)。结论 COPD患者WBC、NEUT%和CRP水平高于健康者,但由于WBC、NEUT%与CRP检测影响因素多,不能对COPD肺部感染进行早期诊断。

Objective To evaluate the clinical value of white blood cell(WBC),neutrophilic granulocyte percentage(NEUT%)and C-reactive protein(CRP)in lung infection of early chronic obstructive pulmonary disease(COPD),and analyse the pathogen distribution.Methods 186 cases of hospitalized patients with COPD were enrolled as research group and 60 healthy ones as control group.Compared WBC,NEUT%,CRP levels between the two groups.According to sputum culture results,patients were divided into normal flora group and pathogen growth group;according to the type of pathogen,patients were divided into G+and G-group.Analyse WBC and CRP levels in each groups and compare sensitivity,specificity and positive predictive value of the two indicators.Distribution of positive sputum culture results were statistically analyzed.Results The levels of three indicators in research group were higher than those in control group(P<0.05).WBC and CRP levels in normal flora and pathogen growth groups were not significantly different(P>0.05).Based on sputum culture positive results,the number of fungi is 86,and Candida albicans were the most accounting for 35.85%.The number of bacteria were 73 strains.Differences in WBC,NEUT% and CRP between G^+ group and G~ -group were not significant(P>0.05).Conclusion WBC,NEUT% and CRP levels in COPD patients were higher than those in healthy group.But due to many factors which could affect the levels of WBC,NEUT%and serum CRP,apreliminary diagnosis of COPD lung infection can′t be made just through the three indicators.