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目的探讨前降钙素(PCT)及C-反应蛋白(CRP)联合测定在有创与无创机械通气的慢性阻塞性肺病(COPD)患者感染程度评价中的价值。方法应用双抗夹心免疫发光法测定血浆PCT含量,散射比浊法测定血浆CRP水平,对32例有创机械通气的COPD患者、30例无创机械通气的COPD患者、25名健康志愿者分别进行血浆PCT和CRP水平的测定。所有患者入院后24 h行急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ评分)测定。结果有创组A-PACHEⅡ评分高于无创组,差异有统计学意义(P<0.05)。对照组PCT和CRP值分别为(0.42±0.19)ng/ml和(1.10±0.30)mg/L,有创机械通气组PCT和CRP值分别为(6.25±4.16)ng/ml和(46.86±18.59)mg/L;无创机械通气组PCT和CRP值分别为(3.35±2.12)ng/ml和(41.29±16.30)mg/L;均较对照组明显升高(P<0.01),有创机械通气组PCT水平明显高于无创通气组,差异有统计学意义(P<0.05),CRP值比较,有创机械通气组高于无创通气组,但差异无统计学意义(P﹥0.05)。结论 PCT及CRP联合测定可以预测有创与无创械通气COPD患者感染程度。
Objective To investigate the value of combination of procalcitonin (PCT) and C-reactive protein (CRP) in the evaluation of infection in patients with chronic obstructive pulmonary disease (COPD) undergoing invasive and noninvasive mechanical ventilation. Methods Plasma PCT levels were measured by double-antibody sandwich immunoassay and plasma CRP levels were measured by nephelometry. Thirty-two COPD patients with invasive mechanical ventilation and 30 COPD patients with noninvasive mechanical ventilation were enrolled. Twenty-five healthy volunteers were divided into two groups: plasma PCT and CRP levels were measured. All patients were admitted to hospital 24 h after acute physiology and chronic health status score system Ⅱ (APACHE Ⅱ score) determination. Results A-PACHEⅡ score in invasive group was higher than non-invasive group, the difference was statistically significant (P <0.05). The PCT and CRP values in the control group were (0.42 ± 0.19) ng / ml and (1.10 ± 0.30) mg / L, respectively, and those in the invasive mechanical ventilation group were (6.25 ± 4.16) ng / ml and (46.86 ± 18.59 ) mg / L; The PCT and CRP values in the noninvasive mechanical ventilation group were (3.35 ± 2.12) ng / ml and (41.29 ± 16.30) mg / L respectively, which were significantly higher than those in the control group The level of PCT was significantly higher in non-invasive ventilation group than in non-invasive ventilation group (P <0.05). CRP was higher in invasive mechanical ventilation group than noninvasive ventilation group, but the difference was not statistically significant (P> 0.05). Conclusion The combination of PCT and CRP can predict the infection of invasive and non-invasive ventilation COPD patients.