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目的探讨慢性阻塞性肺疾病急性加重期(Acute Exacerbation of Chronic Obstructive Pulmonary Disease,AE-COPD)患者降钙素原(Procalcitonin,PCT)水平检测的临床应用价值及其与肺功能指标的关系。方法选取2009年3月至2012年3月在洛阳东方医院住院AECOPD患者84例,采用免疫发光法测定诱导痰和血清中PCT水平,与同期COPD稳定期作对照;AECOPD诱导痰、血清PCT浓度,与第一秒用力呼气容积占预计值百分比(FEV1%预计值)行相关分析;按COPD分级标准分组,比较各组诱导痰、血清PCT水平变化。结果 AECOPD患者诱导痰、血清PCT水平明显增高(t=2.87、t=2.39,P<0.01),诱导痰、血清PCT水平均与FEV1%预计值呈负相关(r=-0.61、r=-0.55,P<0.05),肺功能严重障碍诱导痰PCT水平明显升高。结论 PCT水平对判断AECOPD下呼吸道细菌感染及严重程度有一定的临床价值,与肺功能严重障碍关系密切。
Objective To investigate the clinical value of procalcitonin (PCT) detection in patients with chronic obstructive pulmonary disease (COPD) and its relationship with pulmonary function parameters. Methods Eighty-four AECOPD patients were enrolled in the Oriental Hospital of Luoyang from March 2009 to March 2012. The levels of PCT in induced sputum and serum were measured by immunoluminescence assay and compared with the stable COPD in the same period. AECOPD-induced sputum, serum PCT concentration, And forced expiratory volume of the first second as a percentage of expected value (FEV1% predicted) line correlation analysis; according to COPD grading standards group, compared the induced sputum and serum PCT levels in each group. Results The induced sputum in patients with AECOPD had significantly higher serum PCT levels (t = 2.87, t = 2.39, P <0.01). The induced sputum and serum PCT levels were negatively correlated with the predicted FEV1% (r = -0.61, r = , P <0.05). The level of PCT induced by sputum in patients with severe pulmonary function disorder was significantly higher than that in control group. Conclusions The PCT level has certain clinical value in judging the bacterial infection and severity of AECOPD lower respiratory tract, and is closely related to the severe pulmonary function disorder.