论文部分内容阅读
目的探讨急性时相反应蛋白检测在判断慢性阻塞性肺疾病急性加重(AECOPD)患者感染类型,以及在评判疾病严重程度中的价值。方法选择125例COPD患者为研究对象。检测血清中的α1-酸性糖蛋白(AAG),触珠蛋白(HPT),铜蓝蛋白(CER),转铁蛋白(TRF),C-反应蛋白(CRP),前白蛋白(PAB)。按细菌培养结果分为痰培养阳性组和培养阴性组。按照血气分析结果分为单纯性AECOPD组及AECOPDP伴呼吸衰竭组。结果痰培养阳性组和培养阴性组之间CRP差别有统计学意义(P<0.01),其余指标差别无统计学意义(P>0.05)。区分细菌性AECOPD和非细菌性AECOPD的理想分界点为39.06 mg/L(灵敏度,85.05%,特异度89.61%,AUC,0.852)单纯性AECOPD组AAG,CER与AECOPDP伴呼吸衰竭组差异有统计学意义(P<0.05,P<0.01)其他指标差异均无统计学意义。检验效能CER好于AAG且联合检测意义不大。结论 CRP有助于AECOPD感染类型的早期诊断,CER可作为疾病严重程度的判断指标。
Objective To investigate the value of acute phase reaction protein in determining the type of infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and in evaluating the severity of the disease. Methods 125 patients with COPD were selected as the research object. Serum α1-acid glycoprotein (AAG), haptoglobin (HPT), ceruloplasmin (CER), transferrin (TRF), C-reactive protein (CRP) and prealbumin (PAB) were detected. According to bacterial culture results were divided into sputum culture positive group and culture negative group. According to blood gas analysis results were divided into simple AECOPD group and AECOPDP with respiratory failure group. Results There was a significant difference in CRP between sputum culture positive group and culture negative group (P <0.01). There was no significant difference between the other indexes (P> 0.05). The ideal demarcation points for distinguishing bacterial AECOPD from non-bacterial AECOPD were 39.06 mg / L (sensitivity, 85.05%, specificity of 89.61%, AUC, 0.852). The differences between AEC, AEC and AECOPDP with respiratory failure were statistically significant Significance (P <0.05, P <0.01) There was no significant difference in other indexes. Test efficacy CER is better than AAG and joint detection of little significance. Conclusion CRP is helpful for the early diagnosis of AECOPD infection, and CER can be used as a marker to judge the severity of the disease.