本文選題：降鈣素原　切入點(diǎn)：超敏　出處：《安徽醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的降鈣素原(PCT)由甲狀腺C細(xì)胞生成,正常情況下其值較低,在病理情況下則由甲狀腺以外的組織生成,如肺、肝、肌肉等,在細(xì)菌感染時(shí)其值升高,尤其在膿毒血癥是變化更為明顯。超敏C反應(yīng)蛋白(Hs-CRP)主要由肝細(xì)胞合成,是一種非特異性急性時(shí)相反應(yīng)性蛋白,參與機(jī)體的多項(xiàng)病理生理反應(yīng),正常情況下其在血清的濃度極低,在炎癥、感染時(shí),其血清值會(huì)迅速升高,發(fā)揮抗炎作用,病情控制后迅速下降。本文主要探討血清PCT與hs-CRP在慢性阻塞性肺疾病急性加重期(AECOPD)臨床應(yīng)用價(jià)值。方法選擇我院78例AECOPD住院病人(2013年2月-2014年2月在安徽醫(yī)科大學(xué)阜陽臨床學(xué)院呼吸科住院治療的AECOPD患者)及34例門診隨訪的慢性阻塞性肺疾病(COPD)穩(wěn)定期患者,分別測(cè)定AECOPD患者入院治療前及第10天的血清PCT及hs-CRP水平,以及穩(wěn)定期患者的血清PCT、hs-CRP的濃度。應(yīng)用慢阻肺評(píng)估測(cè)試(CAT)評(píng)分系統(tǒng)評(píng)估觀察組病人治療前后的病情,并同治療前后PCT及hs-CRP血清水平變化作相關(guān)性分析。結(jié)果AECOPD患者治療前血清PCT、hs-CRP的濃度(兩者均數(shù)分別為1.07±0.70、2.34±1.34)明顯高于治療后(均數(shù)分別為0.30±0.19、1.42±1.21)及穩(wěn)定期患者(均數(shù)分別為0.28±0.15、0.83±0.31),并且其診斷陽性率較高,分別80.8%、75.6%,慢性阻塞性肺疾病急性加重期患者治療前后的兩者血清水平變化量同治療前后患者病情變化有明顯的相關(guān)性(相關(guān)性分別為0.88、0.70)。結(jié)論血清PCT及hs-CRP水平測(cè)定是診斷慢性阻塞性肺疾病急性加重的較為敏感指標(biāo),并對(duì)評(píng)估AECOPD患者治療前后病情變化有重要價(jià)值,聯(lián)合檢測(cè)血清PCT和hs-CRP對(duì)AECOPD患者有重要的臨床意義。
[Abstract]:Objective to produce procalcitonin (PCT) from C cells of thyroid gland, which is lower in normal condition and higher in tissues outside thyroid gland in pathological condition, such as lung, liver, muscle, etc. Especially in sepsis, the changes of Hs-CRP are more obvious. Hs-CRP is mainly synthesized by hepatocytes and is a non-specific acute phase reactive protein, which is involved in many pathophysiological reactions. Under normal circumstances, its concentration in the serum is extremely low, and when it is inflamed and infected, its serum value will rise rapidly and play an anti-inflammatory role. The clinical value of serum PCT and hs-CRP in acute exacerbation of chronic obstructive pulmonary disease (COPD) was investigated. Methods 78 AECOPD inpatients in Anhui Medical University from February 2013 to February 2014 were selected. And 34 patients with chronic obstructive pulmonary disease (COPD) who were hospitalized in the respiratory department of Fuyang Clinic, and 34 patients with chronic obstructive Pulmonary Disease (COPD) in outpatient follow-up. The levels of serum PCT and hs-CRP were measured before and 10 days after admission of AECOPD patients, and the serum levels of PCThs-CRP in stable patients were measured respectively. The patients in the observation group were evaluated before and after treatment with the slow obstructive pulmonary assessment (COPD) scoring system. Results before and after treatment, the serum levels of PCT and hs-CRP in AECOPD patients (mean 1.07 鹵0.70 鹵2.34 鹵1.34) were significantly higher than those after treatment (0.30 鹵0.19 鹵1.42 鹵1.21) and stable phase patients (mean, respectively). The positive rate was 0.28 鹵0.15 ~ 0.83 鹵0.31, and the positive rate was higher. The changes of serum levels in patients with acute exacerbation of chronic obstructive pulmonary disease before and after treatment were significantly correlated with those of patients with chronic obstructive pulmonary disease before and after treatment (the correlation was 0.880.700.Conclusion the levels of serum PCT and hs-CRP were determined in patients with acute exacerbation of chronic obstructive pulmonary disease before and after treatment. A sensitive indicator for the diagnosis of acute exacerbation of chronic obstructive pulmonary disease, It is of great value to evaluate the changes of AECOPD patients before and after treatment. The combined detection of serum PCT and hs-CRP is of great clinical significance for AECOPD patients.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R563.9

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