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目的:探讨血清降钙素原在慢性阻塞性肺疾病急性加重期(AECOPD)的变化情况,并总结其临床意义。方法:选取2010年1月~2013年1月间于我院诊治的AECOPD患者132例,所有患者治疗前、后均进行血清降钙素原(PCT)及痰细菌培养,根据治疗前患者痰病原菌浓度分为细菌感染组(56例)和无细菌感染组(76例),此外对细菌感染组患者根据PCT水平进行分组分析。结果:治疗前细菌感染组患者明显高于无细菌感染组,组间差异在统计学上有意义(P<0.05);细菌感染组患者治疗前PCT 12.32±3.05μg/L明显高于治疗后0.46±0.23μg/L,组间差异在统计学上有意义(P<0.05);无细菌感染组患者治疗前PCT 0.45±0.14μg/L与治疗后0.45±0.21μg/L无明显差异,治疗后细菌感染组PCT 0.46±0.23μg/L与无细菌感染组0.45±0.21μg/L无明显差异,以上差异在统计学上均无意义(P>0.05);细菌感染组患者PCT分级越高,患者抗生素应用时间越长、住院时间越长,且治疗好转率越高、死亡率越低,不同分级差异在统计学上有意义(P<0.05)。结论:AECOPD患者血清PCT升高提示可能存在细菌性感染,且其水平分级可指导病情判断、预后评估,值得推广。
Objective: To investigate the changes of serum procalcitonin in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to summarize its clinical significance. Methods: A total of 132 patients with AECOPD who were diagnosed and treated in our hospital from January 2010 to January 2013 were selected. All patients were treated with serum procalcitonin (PCT) and sputum bacterial culture before and after treatment. According to the sputum pathogens Concentrations were divided into bacterial infection group (56 cases) and no bacterial infection group (76 cases). In addition, patients in bacterial infection group were grouped according to PCT level. Results: Before treatment, the bacterial infection group was significantly higher than the non-bacterial infection group, the difference between the groups was statistically significant (P <0.05); before treatment, the bacterial infection group PCT 12.32 ± 3.05μg / L was significantly higher than 0.46 ± 0.23μg / L, there was statistically significant difference between the two groups (P <0.05). There was no significant difference in PCT 0.45 ± 0.14μg / L before treatment and 0.45 ± 0.21μg / L before treatment after treatment There was no significant difference in PCT 0.46 ± 0.23μg / L bacterial infection group and 0.45 ± 0.21μg / L bacterial infection group (P> 0.05). The higher the PCT grade in patients with bacterial infection, The longer the antibiotics were applied, the longer the hospital stay, and the higher the cure rate, the lower the mortality rate. The differences in the grading were statistically significant (P <0.05). Conclusion: The elevated serum PCT in patients with AECOPD suggests that there may be bacterial infection, and its level grading can guide disease judgment and prognosis evaluation, which is worthy of popularization.