摘要
目的探讨血清内毒素、超敏C-反应蛋白(hs-CRP)和降钙素原(PCT)在慢阻肺急性加重期患者诊断及病情评估中的意义。方法选取50例慢阻肺急性加重期患者,对患者进行内毒素、病原学检查,同时对患者进行APACHEⅡ评分;依据内毒素水平分为内毒素阴性组(n=10)和阳性组(n=40),比较不同组患者APACHEⅡ评分、高敏C反应蛋白(hs-CRP)以及降钙素原(PCT)等的水平的差异。结果 50例患者中,内毒素阳性40例(80.0%)。痰及血细菌培养阳性9例(18.0%),包括铜绿假单胞菌1例、金黄色葡萄球菌2例、鲍曼不动杆菌2例、嗜麦芽窄单胞菌4例;不同内毒素水平患者的APACHEⅡ评分比较差异具有统计学意义(P<0.05);内毒素阳性组hs-CRP和PCT显著高于阴性组(P<0.05);内毒素阳性组重度患者血清hs-CRP和PCT显著高于轻度组(P<0.05);Pearson相关检验显示,慢阻肺急性加重期患者血清hs-CRP与患者APACHEⅡ评分存在正相关(P<0.05)。结论慢阻肺急性加重期患者血清内毒素、hs-CRP和PCT显著增高,并可作为患者病情严重程度的血清标志物。
Objective To explore the significance of serum endotoxin, allergic C-reactive protein （hs-CRP） and calcitonin original （PCT） in the evaluation of disease condition in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods A total of 50 patients with AECOPD were selected and conducted with bacterial endotoxin examination, etiology examination and APACHE Ⅱ score evaluation. According to the bacterial endotoxin levels, the pa- tients were divided into endotoxin negative group （n = 10 ） and the positive group （n = 40 ）. Pa- tients with difference APACHE Ⅱ score, hs-CRP and calcitonin original （PCT） levels were com- pared. Results In the 50 cases, there were 40 cases with positive endotoxin expression （80.0%）. Phlegm and blood bacteria culture were positive in 9 cases （ 18.0% ） , including 1 case with pseudo- monas aeruginosa, 2 cases with staphylococcus aureus, 2 cases with acinetobacter baumannii, 4 cases with eosinophilic malt narrow of bacterium. There were significant differences of APACHE Ⅱ score in patients with different levels of endotoxin （P 〈 0.05）. In the endotoxin positive group, hs-CRP and PCT were significantly higher than the negative group （ P 〈 0.05 ）. In the endotoxin positive group, serum hs-CRP and PCT in severe patients were significantly higher than those of mild group （P 〈 0.05）. Pearson correlation test showed that serum hs-CRP was positively correlated with APACHE scorein patients with AECOPD （P 〈 0.05）. Conclusion In patients with AECOPD, serum endotox- in, hs-CRPand PCT increase significantly, and these indexes can be used as the serum markers for severity of symptoms.
出处
《实用临床医药杂志》
CAS
2017年第7期21-23,27,共4页
Journal of Clinical Medicine in Practice
基金
安徽省2015年度教育厅一般项目(KJ2015B016by)
关键词
慢阻肺
急性加重
内毒素
超敏C-反应蛋白
降钙素原
病情评估
COPD
acute exacerbation
endotoxin
allergic C-reactive protein
calcito-nin original
disease condition assessment
作者简介
通信作者：祝立新
