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目的探讨降钙素原(PCT)在慢性阻塞性肺疾病(COPD)合并心力衰竭伴肺部感染患者的早期诊断价值及临床意义。方法 2011年9月-2015年8月,收集本院COPD合并心力衰竭伴肺部感染80例,单纯心力衰竭60例,健康对照者60例,检测3组PCT;记录COPD合并心力衰竭伴肺部感染组痰培养结果;根据美国纽约心脏病协会提出的按诱发心力衰竭症状的活动程度,将心功能的受损状况分为四级(Ⅰ级-Ⅳ级),比较各组PCT;感染菌革兰染色分为革兰阴性菌组、革兰阳性菌组,比较2组PCT。结果 COPD合并心力衰竭伴肺部感染组PCT(10.76μg/L±4.06μg/L)明显高于单纯心力衰竭组(3.56μg/L±0.68μg/L)及健康对照组(0.32μg/L±0.19μg/L),差异有统计学意义(P<0.05);革兰阴性菌53例,多于革兰阳性菌27例;革兰阴性菌组PCT(15.06μg/L±5.11μg/L)明显高于革兰阳性菌组(4.46μg/L±2.68μg/L);PCT与心功能分级呈正相关。结论 PCT有利于早期发现COPD合并心力衰竭伴肺部感染患者,有利于心力衰竭纠正,有助于早期抗感染治疗,避免抗生素滥用。
Objective To investigate the early diagnostic value and clinical significance of procalcitonin (PCT) in patients with chronic obstructive pulmonary disease (COPD) complicated with heart failure and pulmonary infection. Methods From September 2011 to August 2015, 80 COPD patients with heart failure and pulmonary infection were enrolled in this study. 60 cases of simple heart failure, 60 cases of healthy controls and 3 cases of PCT were recorded. COPD patients with heart failure and pulmonary According to the degree of activity induced by heart failure induced by the New York Heart Association in the United States, the impaired cardiac function was divided into four grades (grade Ⅰ-Ⅳ), and the PCT of each group was compared. Blue stain is divided into Gram-negative bacteria group, Gram-positive bacteria group, comparing two groups of PCT. Results The PCT (10.76μg / L ± 4.06μg / L) in patients with COPD complicated with heart failure and pulmonary infection was significantly higher than those in patients with heart failure (3.56μg / L ± 0.68μg / L) and healthy controls (0.32μg / L ± 0.19μg / L), the difference was statistically significant (P <0.05); Gram-negative bacteria 53 cases, more than gram-positive bacteria in 27 cases; Gram-negative bacteria group PCT (15.06μg / L ± 5.11μg / L) Which was significantly higher than that of Gram-positive bacteria (4.46μg / L ± 2.68μg / L). There was a positive correlation between PCT and cardiac function classification. Conclusion PCT is beneficial to early detection of COPD patients with heart failure and pulmonary infection, is conducive to correct heart failure, help early anti-infective treatment, to avoid abuse of antibiotics.