哮喘-慢性阻塞性肺疾病重叠综合征急性加重期血清PCT、总IgE检测的意义

摘要

Objective To investigate the expression and clinical significance of serum procalcitonin (PCT ) and total IgE (T-IgE) in patients with acute exacerbation of asthma-chronic obstructive pulmonary disease o-verlap syndrome (ACOS) .Methods A total of 44 patients with acute exacerbation of ACOS ,51 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD ) ,47 patients with acute attack of bronchial asthma were enrolled in the study ,and all the cases were examined for serum PCT and T-IgE .Re-sults The levels of PCT in the two groups of ACOS and AECOPD were significantly higher than that in the asthma group ,the differences were statistically significant (P<0 .05) ,but there was no statistical significance in PCT levels between ACOS group and AECOPD group (P>0 .05);the levels of T-IgE in ACOS group and asthma group were significantly higher than that in AECOPD group ,the differences were statistically signifi-cant (P<0 .05) ,but there was no statistical significance in T-IgE levels between ACOS group and asthma group (P>0 .05) .With PCT ≥0 .25 ng/mL as critical value ,the positive rates of PCT and T-IgE in 3 groups were 75 .00％ ,78 .41％ ,19 .15％ and 65 .91％ ,9 .80％ ,78 .72％ respectively ,and the positive rates of PCT and T-IgE in ACOS group were both 40 .91％ .Conclusion The value of serum PCT and T-IgE in identifying the diseases in three groups are low ,but the increase of PCT and T-IgE at the same time may be considered as the auxiliary diagnostic basis of ACOS .There may be different phenotypes in ACOS acute attack .%目的 探讨哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)急性加重期患者血清降钙素原(PCT)、总IgE(T-IgE)的表达及临床意义.方法 连续收集44例ACOS急性加重期患者作为ACOS组,51例单纯慢性阻塞性肺疾病(COPD)急性加重期COPD(AECOPD)患者作为AECOPD组,47例单纯支气管哮喘急性发作患者作为哮喘组,所有入组病例均检测血清PCT、T-IgE.结果 ACOS、AECOPD两组血清PCT水平明显高于哮喘组,差异有统计学意义(P<0.05),但ACOS、AECOPD两组PCT水平差异无统计学意义(P>0.05);ACOS、哮喘两组T-IgE水平明显高于AECOPD组,差异有统计学意义(P<0.05),但是ACOS、哮喘组两组T-Ig E水平差异无统计学意义(P>0.05);以PC T≥0.25 ng/m L为临界值,PC T和T-Ig E在3组中的阳性率分别为75.00％ 、78.41％ 、19.15％ 和65.91％ 、9.80％ 、78.72％;ACOS组患者PCT和T-IgE均阳性为40.91％.结论 血清PCT、T-IgE用于鉴别3组疾病的价值较低,但是PCT和T-IgE同时增高可考虑为ACOS的辅助诊断依据;ACOS急性发作可能存在不同发病表型.