Li Yanyan, Xie Linlin, Xin Shuzhen, Li Kaishu
Yanyan Li, Respiratory Department, Binzhou People's Hospital, Shandong 256603, China.
Linlin Xie, Infection Department (II), Binzhou People's Hospital, Shandong 256603, China.
Pak J Med Sci. 2017 May-Jun;33(3):566-569. doi: 10.12669/pjms.333.12554.
To observe the changes in the levels of C-reactive protein (CRP) and procalcitonin (PCT) in serum of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and to compare with the values of CRP in combination with PCT in the diagnosis and treatment of infective exacerbation of COPD.
One hundred and sixty-four patients who developed acute exacerbation of COPD and admitted to the Binzhou People's Hospital from March 2014 to December 2015 were selected. They were divided into an infection group (N=98) and a non-infection group (N=66) according to bacterial culture results of sputum and lung computer tomography (CT) examination results. Moreover, 50 healthy people were selected as a normal control group. The levels of PCT and CRP of the three groups were determined respectively; patients in the infection group and non-infection group were determined again after administration of antibacterial drugs for a period of time. The results were all recorded.
The levels of PCT and CRP of the infection group were significantly higher than those of the non-infection group and the normal control group before treatment, and the difference had statistical significance (P<0.05). The levels of PCT and CRP were (1.97±0.13) μg/L and (7.34±2.66) mg/L respectively in the infection group after treatment, which was much lower than the levels before treatment (P<0.05). The level of PCT of the infection group was remarkably higher than that of the non-infection group after treatment (P<0.05), but the difference of CRP level between the infection group and non-infection group had no statistical significance (P>0.05). The specificity and sensitivity of diagnosing COPD in combination with bacterial infection with PCT or CRP were lower than those of PCT in combination with CRP.
Levels of CRP in combination with PCT is a reliable index for determining the existence of bacterial infection, which is of great clinical guidance significance to the treatment and prognosis assessment of AECOPD patients.
观察慢性阻塞性肺疾病急性加重期（AECOPD）患者血清中C反应蛋白（CRP）和降钙素原（PCT）水平的变化，并比较CRP联合PCT在慢性阻塞性肺疾病感染性加重的诊断和治疗中的价值。
选取2014年3月至2015年12月在滨州市人民医院住院治疗的164例COPD急性加重期患者。根据痰细菌培养结果及肺部计算机断层扫描（CT）检查结果分为感染组（N = 98）和非感染组（N = 66）。另外选取50例健康人作为正常对照组。分别测定三组患者的PCT和CRP水平；感染组和非感染组患者在使用抗菌药物一段时间后再次测定。记录所有结果。
治疗前，感染组患者的PCT和CRP水平显著高于非感染组和正常对照组，差异具有统计学意义（P<0.05）。治疗后，感染组患者的PCT和CRP水平分别为（1.97±0.13）μg/L和（7.34±2.66）mg/L，均显著低于治疗前（P<0.05）。治疗后，感染组患者的PCT水平显著高于非感染组（P<0.05），但感染组与非感染组CRP水平差异无统计学意义（P>0.05）。PCT或CRP单独诊断COPD合并细菌感染的特异性和敏感性均低于PCT联合CRP。
CRP联合PCT水平是判断细菌感染存在的可靠指标，对AECOPD患者的治疗及预后评估具有重要的临床指导意义。
