老年慢性阻塞性肺疾病急性加重期患者外周血PCT、WBC、N％水平变化及意义

摘要

Objective To investigate the changes and clinical significance of procalcitonin (PCT),white blood cell count (WBC) and the proportions of neutrophils (N％) in elderly patients suffering from acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods Seventy-five elderly patients suffering from AECOPD were enrolled,venous blood 2mL was obtained respectively on the day of being hospitalized and the day after steady stage.The serum level of PCT was detected by time-resolved fluoroimmunoassay (TRFIA),WBC and N％ were detected by immunity-turbidity method.Results Serum PCT,WBC and N％ in elderly patients with AECOPD before treatment were 0.17 (0.15 ～0.33) μg/L,(10.8 ± 4.7) × 109/L and 76.4％ ± 10.7％ respectively,after treatment they were 0.08 (0.06 ～ 0.12)μg/L,(8.7 ± 3.2) × 109/L and 64.5％ ± 9.6％ respectively; comparing the two groups,P ＜ 0.01,0.05,0.05.Before the treatment,the number of serum PCT,WBC and N％ positive cases were 60,45 and 48,and after treatment the number of negative cases were 69,57 and 60.The positive rate of PCT was higher than that of WBC and N％ before treatment (all P ＜ 0.05),and the negative rate of PCT in steady stage was higher than the other two (all P ＜ 0.05).Conclusion Serum PCT,WBC and N％ were increased in elderly patients with AECOPD,while decreased after the treatment.Serum PCT,WBC and N％ can be used as indicators of the evaluation in the treatment of AECOPD,and PCT is better than WBC and N％.%目的 观察老年慢性阻塞性肺疾病急性加重期(AECOPD)患者外周血降钙素原(PCT)、白细胞(WBC)、嗜中性粒细胞比例(N％)的水平变化,并探讨其临床意义.方法 选择老年AECOPD患者75例,分别于入院当日及自觉症状好转后次日抽取静脉血2 mL,用荧光增强发射法检测PCT,用血液分析仪检测WBC、N％.结果 治疗前AECOPD患者血清PCT及WBC、N％分别为0.17(0.15 ～0.33)μg/L、(10.8±4.7)×109/L、76.4％±10.7％,治疗后分别为0.08(0.06～0.12) μg/L、(8.7±3.2)×109/L、64.5％±9.6％,两组比较,P＜0.01、0.05、0.05.治疗前后AECOPD患者血清PCT、WBC及N％阳性例数分别为60、45、48例,治疗后阴性例数分别为69、57、60例.治疗前PCT阳性率高于N％、WBC阳性率(P均＜0.05),治疗后PCT阴性率高于WBC、N％阴性率(P均＜0.05).结论 AECOPD患者外周血PCT、WBC、N％水平升高,治疗后降低；三者可作为评价AECOPD疗效的指标,且PCT优于WBC、N％.