Gao Dejie, Chen Xincan, Wu He, Wei Haidong, Wu Jinling
Department of Tuberculosis, Binzhou Tuberculosis Control Center, Binzhou Medical College, Binzhou, Shandong 250000, P.R. China.
Department of Laboratory, Binzhou Center Hospital, Binzhou Medical College, Binzhou, Shandong 256603, P.R. China.
Exp Ther Med. 2017 Jul;14(1):193-198. doi: 10.3892/etm.2017.4496. Epub 2017 May 23.
The level of of procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) in the acute exacerbation of COPD (AECOPD) was investigated. Total of 20 patients with acute exacerbation of COPD who were admitted to the Department of Respiratory Medicine, Binzhou Center Hospital in the period of October 2012 to April 2015 were enrolled in the AECOPD group. According to the color of the sputum, the patients with AECOPD were divided into purulent sputum group (n=8) and non-purulent sputum group (n=12). In addition, 15 healthy people from the outpatient medical center were also selected as healthy control group. The levels of serum PCT and hs-CRP in both groups were determined by chemiluminescence and immunoturbidimetry, respectively for the comparison analysis. The serum PCT concentration in AECOPD group was 2.07±5.57 ng/ml, while that in healthy control group was 0.21±0.17 ng/ml. Significant difference was found between serum PCT levels in the two groups (p<0.05). The serum concentration of hs-CRP in AECOPD group was 3.66±3.95 mg/l, which is significantly higher than that of the healthy control group (0.49±0.17) (p<0.001). In AECOPD group, the sensitivity of PCT, hs-CRP and white blood cell count was 75, 40 and 40%, respectively, while the specificity was 80, 100 and 100%, respectively, indicating that PCT has higher sensitivity than hs-CRP and white blood cell count (p<0.05). However, no significant difference was found in specificity among these three methods (p>0.05). PCT level of the patients in purulent sputum group was 3.72±8.80 ng/ml, while that of the patients in non-purulent sputum group was 0.97±1.06 ng/ml. The serum hs-CRP level of patients in purulent sputum group was 4.94±4.60 mg/l, while that of the patients in non-purulent sputum group was (2.80±3.38 mg/l). Both the above parameters showed no significant difference between the purulent sputum group and the non-purulent sputum group (p>0.05). In conclusion, serum PCT and hs-CRP levels can be used as auxiliary diagnosis index for acute exacerbation of COPD. Measurement of serum PCT and hs-CRP levels in patients with AECOPD may be helpful in guiding antibacterial drug therapy.
对慢性阻塞性肺疾病急性加重期（AECOPD）患者的降钙素原（PCT）和高敏C反应蛋白（hs-CRP）水平进行了研究。选取2012年10月至2015年4月期间在滨州市中心医院呼吸内科住院的20例COPD急性加重期患者作为AECOPD组。根据痰液颜色，将AECOPD患者分为脓性痰组（n = 8）和非脓性痰组（n = 12）。此外，选取门诊医疗中心的15名健康人作为健康对照组。分别采用化学发光法和免疫比浊法测定两组患者血清PCT和hs-CRP水平，进行对比分析。AECOPD组血清PCT浓度为2.07±5.57 ng/ml，健康对照组为0.21±0.17 ng/ml。两组血清PCT水平差异有统计学意义（p<0.05）。AECOPD组血清hs-CRP浓度为3.66±3.95 mg/l，显著高于健康对照组（0.49±0.17）（p<0.001）。在AECOPD组中，PCT、hs-CRP和白细胞计数的敏感性分别为75%、40%和40%，特异性分别为80%、100%和100%，表明PCT的敏感性高于hs-CRP和白细胞计数（p<0.05）。然而，这三种方法的特异性差异无统计学意义（p>0.05）。脓性痰组患者的PCT水平为3.72±8.80 ng/ml，非脓性痰组患者为0.97±1.06 ng/ml。脓性痰组患者血清hs-CRP水平为4.94±4.60 mg/l，非脓性痰组患者为（2.80±3.38 mg/l）。上述两个参数在脓性痰组和非脓性痰组之间差异均无统计学意义（p>0.05）。综上所述，血清PCT和hs-CRP水平可作为COPD急性加重期的辅助诊断指标。检测AECOPD患者血清PCT和hs-CRP水平可能有助于指导抗菌药物治疗。
