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目的探讨降钙素原和炎性反应因子在慢性阻塞性肺疾病(COPD)急性加重期诱因鉴别中的价值。方法根据诱因将COPD急性加重期患者90例分为感染组(INF组)和非感染组(CON组)各45例。比较2组患者稳定期和急性加重期白细胞、降钙素原和炎性因子的差异。结果 2组患者稳定期白细胞(WBC)、中性粒细胞(NEU)和淋巴细胞(LYM)均无明显差异(P>0.05);CON组患者急性加重期WBC、NEU和LYM与稳定期比较无明显差异(P>0.05)。INF组患者急性加重期WBC、NEU和LYM显著高于稳定期及CON组患者,差异均有统计学意义(P<0.05)。2组患者稳定期降钙素原、均无明显差异(P>0.05);CON组患者急性加重期降钙素原、hs-CRP、TNF-α、IL-6、IL-8和IL-10与稳定期相比无明显差异(P>0.05),INF组患者急性加重期降钙素原、hs-CRP、TNF-α、IL-6、IL-8显著高于稳定期及CON组,IL-10显著低于稳定期及CON组,差异均有统计学意义(P<0.05)。结论 COPD急性加重期白细胞、降钙素原和炎性因子水平显著升高,可用于鉴别感染性和非感染性诱因。
Objective To investigate the value of procalcitonin and proinflammatory cytokines in the identification of causes of acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Ninety patients with acute exacerbation of COPD were divided into infection group (INF group) and non-infection group (CON group), 45 cases in each group. The differences of leukocyte, procalcitonin and inflammatory cytokines in stable and acute exacerbation were compared between the two groups. Results There were no significant differences in WBC, NEU and LYM between the two groups (P> 0.05). The WBC, NEU and LYM in the CON group were significantly lower than those in the stable phase Significant difference (P> 0.05). The WBC, NEU and LYM were significantly higher in INF group than in stable group and CON group (P <0.05). The levels of procalcitonin, hs-CRP, TNF-α, IL-6, IL-8 and IL-10 in patients with acute exacerbation of CON group were significantly higher than those of patients in CON group (P> 0.05). The levels of procalcitonin, hs-CRP, TNF-α, IL-6 and IL-8 in acute exacerbation group were significantly higher than those in control group and CON group -10 was significantly lower than that in the stable and CON groups (P <0.05). Conclusion The levels of leukocytes, procalcitonin and inflammatory cytokines in acute exacerbation of COPD are significantly increased, which can be used to identify infectious and non-infectious causes.