血清降钙素原和C反应蛋白联合检测在慢性阻塞性肺疾病患者感染中的临床研究

摘要

目的：评价降钙素原（procalcitonin, PCT）和C反应蛋白（C-reactive protein, CRP）联合检测对慢性阻塞性肺疾病患者感染的诊断及疗效评估的价值。方法对急诊的60例慢性阻塞性肺疾病感染患者血清PCT、CRP的含量及动态变化进行检测，同时将60例感染患者分为重症感染组（n=28）和轻度感染组（n=32），并与30例非感染组进行比较。结果重症感染组血清PCT、CRP浓度分别为（5.32±3.21）ng/mL和（16.51±6.82）mg/L，轻度感染组血清PCT、CRP浓度分别为（1.25±1.11）ng/mL和（10.11±4.50）mg/L，均明显高于非感染组[（0.24±0.21）ng/mL，（3.52±2.22）mg/L]，差异有统计学意义（P＜0.01）。经有效抗菌治疗后感染患者的PCT、CRP浓度均下降，与治疗前相比差异有统计学意义（P＜0.01）。以PCT≥0.5 ng/mL、CRP≥8 mg/L为界，PCT与CRP诊断细菌感染的敏感性均为88.3%，PCT的特异性（93.3%）高于CRP（76.7%）。结论血清PCT、CRP联合检测有助于慢性阻塞性肺疾病患者感染的早期诊断，PCT的特异性要优于CRP，动态监测PCT水平有助于评估治疗效果且具有很高的临床应用价值。%Objective To evaluate the clinical value of combined determination of serum procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis and assessment of therapeutic effect for patients with chronic obstructive pulmonary disease infection.Methods Serum PCT and CRP levels and their dynamic changes in 60 patients with chronic obstructive pulmonary disease infection in Emergency Department were measured. The infected patients were assigned to serious infection group (n=28) and mild infection group (n=32). The results were analyzed and compared with those of non-infection group (n=30).Results The levels of PCT and CRP were (5.32±3.21) ng/mL and (16.51±6.82) mg/L respectively in serious infection group and (1.25±1.11) ng/mL and (10.11±4.50) mg/L, respectively in mild infection group, which were all signifi cantly higher compared with those in non-infection group ([0.24±0.21] ng/mL, [3.52±2.22] mg/L,P<0.01). After antibiotic treatment, the levels of PCT and CRP in infected patients decreased signifi cantly (P<0.01). Based on the cut-off values of PCT≥0.5 ng/mL and CRP≥8 mg/L for the diagnosis of infections, the sensitivity of PCT and CRP were all 88.3%, the specifi city of PCT (93.3%) was higher than that of CRP (76.7%). Conclusion The combined determination of PCT and CRP assists the early diagnosis of chronic obstructive pulmonary disease infections. The specifi city of PCT is higher than that of CRP. Dynamic monitoring of PCT levels helps to assess the therapeutic effect and has a high clinical value.