孙吉鹏

[摘要] 目的 探讨PCT（血清降钙素原）和CRP（C反应蛋白）在慢性阻塞性肺疾病急性加重（AECOPD）患者发生细菌感染的诊断价值。方法 方便选取该院2016年6月—2017年6月收治的80例AECOPD患者，将合并感染的56例纳入感染组，将未合并感染的34例患者纳入非感染组，在患者治疗前和治疗后分别检测患者血清PCT和CRP水平。结果 治疗前感染组患者的PCT水平为（1.63±0.66）ng/mL，显著高于非感染组的（0.92±0.41）ng/mL，两组治疗前的CRP水平对比差异无统计学意义[（19.59±6.73）mg/L vs（17.73±6.82）mg/L]，两组治疗后的PCT和CRP水平均显著降低（P<0.05），但组间比较差异无统计学意义（P>0.05）。PCT诊断敏感度为94.64%，与CRP的91.07%相当（P>0.05）；PCT诊断特异度为88.24%，显著高于CRP的73.53%（P<0.05）。结论 PCT和CRP均参与了AECOPD的发病过程，且PCT诊断患者是否细菌感染的特异性較CRP高。

[关键词] C反应蛋白；慢性阻塞性肺疾病；细菌感染；降钙素原

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）01（a）-0029-03

7

The Value of PCT and CRP in the Diagnosis of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

SUN Ji-peng

Department of Laboratory， Yantai Harbor Hospital， Yantai， Shandong Province， 264000 China

[Abstract] Objective This paper tries to investigate the value of PCT and CRP in the diagnosis of bacterial infection in AECOPD patients. Methods 80 cases of AECOPD patients in the hospital from June 2016 to June 2017 were convenient selected， the combined infection group included 56 patients， 34 cases of infected patients were merged into non-infection group， patients before and after treatment with PCT and CRP levels were measured. Results The level of PCT in the infection group before treatment was（1.63±0.66）ng/mL， which was significantly higher than that in the non infection group （0.92±0.41）ng/mL， there was no significant difference in the CRP levels between the two groups [（19.59±6.73）mg/L vs （17.73±6.82）mg/L]， levels of PCT and CRP were significantly lower in the two groups（P<0.05）， but there was no significant difference between the two groups（P>0.05）. The sensitivity of PCT diagnosis was 94.64%， which was equivalent to 91.07% of CRP（P>0.05）； diagnostic specificity of PCT was 88.24%， significantly higher than 73.53% of CRP（P<0.05）. Conclusion PCT and CRP were involved in the pathogenesis of AECOPD， and the specificity of bacterial infection in patients with PCT diagnosis was higher than that of CRP.

[Key words] CRP； COPD； Bacterial infection； PCT

支气管炎、急性上呼吸道感染等均是导致AECOPD的常见原因，肺炎链球菌、肺炎支原体、铜绿假单胞菌、流感嗜血杆菌等为患者常见的病原体，病毒也常参与呼吸道感染[1]。在反复发作的AECOPD住院患者中，主要以铜绿假单胞菌和肠杆菌多见。同时，心律失常、心力衰竭、精神情绪、气候改变、气胸等肺感染因素也是AECOPD的主要诱因[2]。PCT和CRP为细菌感染诊断和鉴别的血清标志物，并且其在血清中的含量和患者感染程度密切相关[3]。该研究纳入该院2016年6月—2017年6月收治的80例AECOPD患者进行分析，观察感染患者和非感染患者治疗前后血清PCT和CRP水平，探讨其在AECOPD细菌感染患者中的诊断价值，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的80例AECOPD患者作为研究对象，患者治疗前均明确确诊[4]，均知情同意，排除治疗前急性加重期病程超过5 d患者，入院前前4周内使用抗生素患者，合并其他呼吸道疾病患者。痰……