State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Laboratory Center, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi, 830000, China.
First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China.
Dis Markers. 2021 Mar 15;2021:8879401. doi: 10.1155/2021/8879401. eCollection 2021.
Currently, standards of antibiotic use in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients are controversial.
The aim of the present study was to analyze the value of procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) levels to guide the antibiotic treatment of AECOPD patients.
A total of 371 patients with COPD or AECOPD were included in the study. Clinical and laboratory data were obtained at admission, 325 AECOPD patients and 46 sCOPD patients treated with antibiotics. The receiver operating curve (ROC) was used to evaluate the relationship between CRP, PCT, and IL-6.
This study included medical record/case control 1, the COPD group ( = 46) and the AECOPD group ( = 325), and medical record control 2, the nonchanged antibiotic group ( = 203) and the changed antibiotic group ( = 61). In case 1, CRP, PCT, and IL-6 levels in the AECOPD group were higher than that in the control group ( < 0.05), while the result of ROC showed that IL-6 had higher AUC values (0.773) and higher sensitivity (71.7%) than other indicators. The specificity of PCT (93.5%) is higher than other indicators. In case 2, ROC curve results showed that the AUC value of IL-6 (0.771) was slightly higher than PCT and CRP. The sensitivity (85.2%) and specificity (65.5%) of CRP were higher than other indicators.
IL-6 and PCT were elevated in AECOPD patients, resulting in a higher diagnostic value for AECOPD. CRP had a higher diagnostic value for antibiotic use in AECOPD patients.
目前，慢性阻塞性肺疾病急性加重（AECOPD）患者抗生素使用标准存在争议。
本研究旨在分析降钙素原（PCT）、C 反应蛋白（CRP）和白细胞介素 6（IL-6）水平对 AECOPD 患者抗生素治疗的指导价值。
共纳入 371 例 COPD 或 AECOPD 患者。入院时采集临床和实验室数据，对 325 例 AECOPD 患者和 46 例 sCOPD 患者进行抗生素治疗。采用受试者工作特征曲线（ROC）评估 CRP、PCT 和 IL-6 之间的关系。
本研究包括病历/病例对照 1，COPD 组（n=46）和 AECOPD 组（n=325），以及病历对照 2，未改变抗生素组（n=203）和改变抗生素组（n=61）。在病例 1 中，AECOPD 组 CRP、PCT 和 IL-6 水平高于对照组（P<0.05），而 ROC 结果显示，IL-6 的 AUC 值（0.773）和灵敏度（71.7%）均高于其他指标。PCT（93.5%）的特异性高于其他指标。在病例 2 中，ROC 曲线结果显示，IL-6（0.771）的 AUC 值略高于 PCT 和 CRP。CRP 的灵敏度（85.2%）和特异性（65.5%）高于其他指标。
AECOPD 患者 IL-6 和 PCT 升高，对 AECOPD 的诊断价值较高。CRP 对 AECOPD 患者抗生素使用具有更高的诊断价值。
