血清BNP PCT和SAA检测对慢性阻塞性肺病急性加重期的诊断价值

摘要

Objective To?study?the?detection?of?serum?amyloid?protein?A(SAA),brain?natriuretic?peptide(BNP)and?procalcitonin(PCT) in?chronic?obstructive?pulmonary?disease(COPD)?and?assess?the?diagnostic?value?of?acute?exacerbation?period(AECOPD).?Methods? 87?cases?of?patients?with?acute?exacerbation?of?COPD?and?64?patients?with?COPD?were?treated?in?the?respiratory?department?of?our?hospital.?Phlegm?culture?was?performed?and?PCT,SAA?and?BNP?were?measured.?Results? PCT,SAA?and?BNP?detection?levels?of?COPD?stable?patients?were?significantly?lower?than?those?of?AECOPD?patients(P<0.05).?The?PCT?and?SAA?levels?of?positive?sputum?culture?patients?in?the?AECOPD?group?were?significantly?higher?than?the?COPD?stable?group(P<0.01),and?SAA?level?in?the?AECOPD?group?were?significantly?higher?than?COPD?stable?group(P<0.01).?The?BNP?level?of?patients?with?COPD?combined?with?heart?failure?was?significantly?higher?than?patients?with?COPD?uncombined?with?heart?failure(P<0.01). Conclusion? BNP,PCT?and?SAA?both?have?diagnostic?value?in?patients?with?AECOPD.?PCT?has?more?diagnostic?value?than?SAA?in?bacterial?infection?during?acute?exacerbation?of?COPD.?The?test?provides?clinical?guidance?for?the?diagnosis?and?treatment?of?AECOPD.%目的 探讨血清淀粉样蛋白A(SAA)、B型利尿钠肽(BNP)和降钙素原(PCT)在慢性阻塞性肺病急性加重期(AECOPD)的诊断价值.方法 COPD急性加重期患者87例和COPD稳定期患者64例,分别做痰培养和测定PCT、SAA及BNP.结果 COPD稳定期患者PCT、SAA及BNP检测水平明显低于AECOPD患者(P<0.05);AECOPD组痰培养阳性患者PCT、SAA水平均明显高于COPD稳定组(P<0.01),AECOPD组痰培养阴性患者SAA水平明显高于COPD稳定组(P<0.01);COPD合并心力衰竭患者BNP水平明显高于COPD未合并心力衰竭患者(P<0.01).结论 BNP、PCT和SAA对AECOPD患者均有诊断价值,PCT比SAA在AECOPD的细菌性感染中更有诊断意义,三者检测对AECOPD的诊断和治疗提供临床指导.