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目的探讨C反应蛋白(CRP)、白细胞(WBC)、嗜中性粒细胞比例(N%)、PO2、PCO2在慢性阻塞性肺疾病(COPD)急性加重期诊治中的临床意义。方法选择COPD急性加重期患者71例,比较治疗前及症状好转时血清CRP水平、WBC总数、N%、PO2、PCO2动态变化情况,观察上述指标及症状好转天数、住院总天数的相关性。结果①CRP在急性加重期较正常组显著升高(P<0.01);CRP、WBC、N%、PCO2水平在症状好转时明显低于COPD急性加重期(P<0.01),PO2水平在症状好转时明显高于COPD急性加重期(P<0.01)。②COPD病人急性加重期CRP、WBC、N%与PO2、PCO2之间均无明显相关(P均>0.05),N%与症状好转天数(r=0.240,P<0.05)、症状好转天数与住院总天数之间(r=0.567,P<0.01)则存在相关性。结论血清CRP水平、WBC总数、N%均可作为评价COPD急性加重期患者感染的客观指标,其中N%尚可作为判定COPD急性加重后症状好转时限的可靠指标,其价值优于CRP和WBC。
Objective To investigate the clinical significance of C reactive protein (CRP), white blood cell (WBC), neutrophil ratio (N%), PO2 and PCO2 in diagnosis and treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Seventy one patients with acute exacerbation of COPD were enrolled in this study. The levels of serum CRP, the total number of WBC, N%, PO2 and PCO2 before and during the improvement of symptoms were compared. The correlation between these indexes and the days of symptom improvement and total days of hospitalization were observed. Results ① The levels of CRP in acute exacerbation were significantly higher than those in normal controls (P <0.01). The levels of CRP, WBC, N% and PCO2 were significantly lower than those in acute exacerbations of COPD (P <0.01) Significantly higher than the exacerbation of COPD (P <0.01). ② There was no significant correlation between CRP, NBC and PO2 and PCO2 in COPD patients (P> 0.05), N% and symptom improvement days (r = 0.240, P <0.05) There was a correlation between days (r = 0.567, P <0.01). Conclusions Serum CRP levels, total number of WBCs and N% can be used as objective indicators for evaluating patients with acute exacerbation of COPD. Among them, N% can still be used as a reliable indicator to determine the time limit for symptom improvement after acute exacerbation of COPD, which is superior to CRP and WBC.