中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
36期
308-309
,共2页
降钙素原%C-反应蛋白%慢性阻塞性肺疾病急性加重期
降鈣素原%C-反應蛋白%慢性阻塞性肺疾病急性加重期
강개소원%C-반응단백%만성조새성폐질병급성가중기
Procalcitonin%C-reactive protein%Acute exacerbation of chronic obstructive pulmonary disease
目的：探讨检测血清降钙素原（procalcitonin，PCT）、C-反应蛋白（C-reactive protein，CRP）水平对指导细菌感染引起慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者临床诊治中的意义。方法对AECOPD患者58例(A组)及COPD稳定期患者31例（B组），采用免疫发光法测定其血清PCT及CRP水平,并进行诱导痰细菌定量培养；以痰中下呼吸道潜在病原菌(PPM)浓度107CFU/mL作为诊断AECOPD细菌感染的标准，将AECOPD患者分为有细菌感染组(A1组35例)、无细菌感染组(A2组23例)。结果 AECOPD有细菌感染组血清PCT（0.22±0.03）ng/mL，CRP（59.79±10.23）mg/mL水平高于无细菌感染组PCT（0.11±0.02）ng/mL，CRP（18.34±3.15）mg/mL及稳定期组PCT（0.08±0.01）ng/mL，CRP（10.06±1.63）mg/mL，差异有统计学意义(P<0.05)。COPD急性加重期无细菌感染组PCT（0.11±0.02）ng/mL水平高于稳定期组PCT（0.08±0.01）ng/mL，差异无统计学意义(P>0.05)，急性加重期无细菌感染组CRP（18.34±3.15）mg/mL水平高于CRP（10.06±1.63）mg/mL，差异有统计学意义(P<0.05)。结论 COPD患者PCT水平升高可能与细菌感染有关、而CRP水平升高可能提示急性加重，联合检测血清PCT及CRP可以帮助了解AECOPD的细菌感染及指导抗生素应用。
目的：探討檢測血清降鈣素原（procalcitonin，PCT）、C-反應蛋白（C-reactive protein，CRP）水平對指導細菌感染引起慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者臨床診治中的意義。方法對AECOPD患者58例(A組)及COPD穩定期患者31例（B組），採用免疫髮光法測定其血清PCT及CRP水平,併進行誘導痰細菌定量培養；以痰中下呼吸道潛在病原菌(PPM)濃度107CFU/mL作為診斷AECOPD細菌感染的標準，將AECOPD患者分為有細菌感染組(A1組35例)、無細菌感染組(A2組23例)。結果 AECOPD有細菌感染組血清PCT（0.22±0.03）ng/mL，CRP（59.79±10.23）mg/mL水平高于無細菌感染組PCT（0.11±0.02）ng/mL，CRP（18.34±3.15）mg/mL及穩定期組PCT（0.08±0.01）ng/mL，CRP（10.06±1.63）mg/mL，差異有統計學意義(P<0.05)。COPD急性加重期無細菌感染組PCT（0.11±0.02）ng/mL水平高于穩定期組PCT（0.08±0.01）ng/mL，差異無統計學意義(P>0.05)，急性加重期無細菌感染組CRP（18.34±3.15）mg/mL水平高于CRP（10.06±1.63）mg/mL，差異有統計學意義(P<0.05)。結論 COPD患者PCT水平升高可能與細菌感染有關、而CRP水平升高可能提示急性加重，聯閤檢測血清PCT及CRP可以幫助瞭解AECOPD的細菌感染及指導抗生素應用。
목적：탐토검측혈청강개소원（procalcitonin，PCT）、C-반응단백（C-reactive protein，CRP）수평대지도세균감염인기만성조새성폐질병급성가중기（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）환자림상진치중적의의。방법대AECOPD환자58례(A조)급COPD은정기환자31례（B조），채용면역발광법측정기혈청PCT급CRP수평,병진행유도담세균정량배양；이담중하호흡도잠재병원균(PPM)농도107CFU/mL작위진단AECOPD세균감염적표준，장AECOPD환자분위유세균감염조(A1조35례)、무세균감염조(A2조23례)。결과 AECOPD유세균감염조혈청PCT（0.22±0.03）ng/mL，CRP（59.79±10.23）mg/mL수평고우무세균감염조PCT（0.11±0.02）ng/mL，CRP（18.34±3.15）mg/mL급은정기조PCT（0.08±0.01）ng/mL，CRP（10.06±1.63）mg/mL，차이유통계학의의(P<0.05)。COPD급성가중기무세균감염조PCT（0.11±0.02）ng/mL수평고우은정기조PCT（0.08±0.01）ng/mL，차이무통계학의의(P>0.05)，급성가중기무세균감염조CRP（18.34±3.15）mg/mL수평고우CRP（10.06±1.63）mg/mL，차이유통계학의의(P<0.05)。결론 COPD환자PCT수평승고가능여세균감염유관、이CRP수평승고가능제시급성가중，연합검측혈청PCT급CRP가이방조료해AECOPD적세균감염급지도항생소응용。
Objective To evaluate the clinical significance of concurrent determination of serum procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis of bacterial infection in acute exacerbation of chronic obstructive pulmonary disease patients. Methods The serum PCT and CRP level of 58 AECOPD patients and 31 stable COPD patients was measured by immunofluorescence method, and the 58 AECOPD patients were simultaneously done semi-quantitative sputum culture, PPMs were only regarded as significant if they reached a growth of 107cfu/mL, indicating the presence of bacterial infection. Results The serum level of PCT and CRP in the bacterial infection AECOPD group was(0.22±0.03)ng/mL and (59.79±10.23)mg/mL respectively, which were much higher than those without bacterial infection AECOPD group(0.11±0.02)ng/mL and (18.34±3.15)mg/mL respectively, also much higher than those stable COPD group(0.08±0.01)ng/mL and (10.06±1.63)mg/mL. There was statistical difference between bacterial infection group and without bacterial infection group (P<0.05). There was not statistic difference between the serum level of PCT without bacterial infection AECOPD group and stable COPD group (P>0.05), and there was statistic difference between the serum level of CRP without bacterial infection AECOPD group and stable COPD group (P<0.05). Conclusion The serum PCT level is some clinical value for judging bacterial infection of COPD, the serum CRP level is some clinical value for judging AECOPD. The combined detection of PCT and CRP level is clinical value for judging bacterial infection of COPD and offer a guidance of AECOPD.
