C反应蛋白和降钙素原在慢性阻塞性肺疾病各阶段的动态变化
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摘要
目的:探讨C反应蛋白(CRP)和降钙素原(PCT)在慢性阻塞性肺疾病(COPD)各阶段中的动态变化及临床意义。方法:选取COPD急性加重期并肺心病患者(肺心病组30例)、COPD急性加重期患者(AECOPD组30例)、COPD稳定期患者(COPD组20例)以及健康体检者20例,分别检测各组血清CRP、PCT水平。结果:肺心病组、AECOPD组、COPD组患者血清CRP [(42.44±10.28)、(27.23±5.66)、(6.82±2.10) mg/L]、PCT[(0.72±0.17)、(0.45±0.11)、(0.18±0.05) ng/mL]均高于健康对照组(P<0.05);肺心病组CRP、PCT高于AECOPD组(P<0.05),AECOPD组CRP、PCT高于COPD组(P<0.05),COPD组、AECOPD组、肺心病组CRP、PCT呈逐渐递增趋势(P <0.05)。结论:CRP、PCT可作为评估COPD病情变化及病情严重程度的良好指标,为尽早预测及判断疾病变化提供临床诊疗依据。
Objective:To investigate the dynamic changes and clinical significance of C-reactive protein(CRP) and procalcitonin(PCT) in various stages of chronic obstructive pulmonary disease(COPD).Methods:Including the patients with acute exacerbation and cor pulmonale(30 patients in cor pulmonale group),the patients with acute exacerbation of COPD(30 patients in AECOPD group),the patients with COPD in stable stage(20 patients in COPD group),and 20 healthy controls were selected,and then the Serum CRP and PCT levels of each group were detected respectively.Results:The serum CRP[(42.44±10.28),(27.23± 5.66),(6.82±2.10) mg/L]and PCT[(0.72±0.17),(0.45±0.11),(0.18±0.05) ng/mL]levels in the patients of cor pulmonale group,AECOPD group,and COPD group were all higher than those in the healthy control group(P<0.05).The CRP and PCT levels in the cor pulmonale group were higher than those in AECOPD group(P<0.05),the CRP and PCT levels in AECOPD group were higher than those in COPD group(P<0.05).The CRP and PCT levels in COPD group,AECOPD group and cor pulmonale group were gradually increasing.Conclusion:The dynamic detection of CRP and PCT is of great significance to the determination of disease change and severity in COPD patients.
Objective:To investigate the dynamic changes and clinical significance of C-reactive protein(CRP) and procalcitonin(PCT) in various stages of chronic obstructive pulmonary disease(COPD).Methods:Including the patients with acute exacerbation and cor pulmonale(30 patients in cor pulmonale group),the patients with acute exacerbation of COPD(30 patients in AECOPD group),the patients with COPD in stable stage(20 patients in COPD group),and 20 healthy controls were selected,and then the Serum CRP and PCT levels of each group were detected respectively.Results:The serum CRP[(42.44±10.28),(27.23± 5.66),(6.82±2.10) mg/L]and PCT[(0.72±0.17),(0.45±0.11),(0.18±0.05) ng/mL]levels in the patients of cor pulmonale group,AECOPD group,and COPD group were all higher than those in the healthy control group(P<0.05).The CRP and PCT levels in the cor pulmonale group were higher than those in AECOPD group(P<0.05),the CRP and PCT levels in AECOPD group were higher than those in COPD group(P<0.05).The CRP and PCT levels in COPD group,AECOPD group and cor pulmonale group were gradually increasing.Conclusion:The dynamic detection of CRP and PCT is of great significance to the determination of disease change and severity in COPD patients.
引文
[1]蔡柏蔷.慢性阻塞性肺疾病诊断、处理和预防全球策(2017GOLD报告)解读版[J].国际呼吸杂志,2017,37(1):6-17.
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[6]Duran L,Unsal M,Yardan T,et al.The evaluation of serum pentraxin-3 and high-sensitivity c-reactive protein levels in patients with acute attack of COPD[J].Clin Lab Med,2015,61(12):1911-1916.
[7]Ansarin K,Rashidi F,Namdar H,et al.Echocardiographic evaluation of the relationship between inflammatory factors(IL6,TNF-α,hs-CRP)and secondary pulmonary hypertension in patients with COPD.A crosssectional study[J].Pneumologia,2015,64(3):31-35.
[8]Milacic'N,Milacic'B,Milojkovic'M,et al.Correlation of C-reactive protein and COPD severity[J].Acta Clin Croat,2016,55(1):41-48.
[9]蒋凌志,徐丹媛,杨志雄.老年COPD患者血清PCT、hs-CRP的表达与肺功能指标、生活质量的相关性[J].中国老年学杂志,2018,38(7):1623-1625.
[10]Lacoma A,Prat C,Andreo F,et al.Value of procalcitonin,C-reactive protein,and neopterin in exacerbations of chronic obstructive pulmonary disease.Int J Chron Obstruct Pulmon Dis,2011(6):157-169.
[11]Apfaltrer P,Sudarski S,Schneider D,et al.Value of monoenergetic low-kV dual energy CT datasets for improved image quality of CTpulmonary angiography[J],European Journal of Radiology,2014,83(2):322-328.
[2]唐丹丹,何家富.降钙素原及炎症因子在COPD病情及预后评估中的作用[J].临床肺科杂志,2013,18(11):2112-2113.
[3]申永春,文富强.2018年慢性阻塞性肺疾病全球创议更新解读[J].中国实用内科杂志,2018,38(5):443-445.
[4]中华医学会.慢性肺源性心脏病基层诊疗指南(2018年)[J].中华全科医师杂志,2018,17(12):959-965.
[5]王永.慢性阻塞性肺疾病急性加重期与稳定期超敏C反应蛋白测定对比研究[J].临床肺科杂志,2014,19(7):1233-1236.
[6]Duran L,Unsal M,Yardan T,et al.The evaluation of serum pentraxin-3 and high-sensitivity c-reactive protein levels in patients with acute attack of COPD[J].Clin Lab Med,2015,61(12):1911-1916.
[7]Ansarin K,Rashidi F,Namdar H,et al.Echocardiographic evaluation of the relationship between inflammatory factors(IL6,TNF-α,hs-CRP)and secondary pulmonary hypertension in patients with COPD.A crosssectional study[J].Pneumologia,2015,64(3):31-35.
[8]Milacic'N,Milacic'B,Milojkovic'M,et al.Correlation of C-reactive protein and COPD severity[J].Acta Clin Croat,2016,55(1):41-48.
[9]蒋凌志,徐丹媛,杨志雄.老年COPD患者血清PCT、hs-CRP的表达与肺功能指标、生活质量的相关性[J].中国老年学杂志,2018,38(7):1623-1625.
[10]Lacoma A,Prat C,Andreo F,et al.Value of procalcitonin,C-reactive protein,and neopterin in exacerbations of chronic obstructive pulmonary disease.Int J Chron Obstruct Pulmon Dis,2011(6):157-169.
[11]Apfaltrer P,Sudarski S,Schneider D,et al.Value of monoenergetic low-kV dual energy CT datasets for improved image quality of CTpulmonary angiography[J],European Journal of Radiology,2014,83(2):322-328.