本文選題：慢性阻塞性肺疾病 + 急性加重　； 參考：《昆明醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：觀察降鈣素原(Procalcitonin, PCT)、C-反應(yīng)蛋白(C-reactive protein,CRP)在慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease, AECOPD)的變化及相關(guān)性,了解其對評估AECOPD嚴重程度、AECOPD合并肺炎的診斷等的參考價值。方法：按照設(shè)計的要求,選取2013年9月至2014年12月在昆明醫(yī)科大學(xué)第一附屬醫(yī)院呼吸內(nèi)科住院的COPD患者219例,分為AECOPD組(n=106)和AECOPD伴肺炎組(n=113)兩組。其中AECOPD組按照2014年慢性阻塞性肺疾病全球倡議(The Global Initiative for Chronic Obstructive Lung Disease, GOLD)標準分為AECOPD-B組(n=33)、C組(n=30)、D組(n=43)三組。檢測和收集AECOPD組、AECOPD伴肺炎組兩組患者的白細胞(White blood cells, WBC)水平、中性粒細胞(Neutrophils, N)百分數(shù)水平、PCT水平,CRP水平、住院時間、抗菌治療療程、住院費用等,再將PCT、CRP分別與上述其余指標的相關(guān)性進行分析。結(jié)果：1、AECOPD伴肺炎組的WBC、N、PCT、住院時間、抗菌治療療程、住院費用明顯高于AECOPD組,差異有統(tǒng)計學(xué)意義(P0.05),兩組CRP的差異無統(tǒng)計學(xué)意義(P0.05)。2、AECOPD組PCT與住院時間、抗菌治療療程、住院費用存在一定正相關(guān)關(guān)系(r=0.32、0.32、0.231,P0.05),與WBC、N.CRP無相關(guān)性(P0.05), CRP與WBC、N存在一定正相關(guān)關(guān)系(r=0.372、0.209,P0.05),與PCT、住院時間、抗菌治療療程、住院費用無相關(guān)性(P0.05)。AECOPD伴肺炎組患者PCT與WBC, N, CRP存在一定正相關(guān)關(guān)系(r=0.202、0.309、0.293,P0.05),與住院時間、抗菌治療療程、住院費用無相關(guān)性(P0.05), CRP與WBC、N、PCT存在一定正相關(guān)關(guān)系(r=0.299、0.35、0.293,P0.05),與住院時間、抗菌治療療程、住院費用無相關(guān)性(P0.05)。3、AECOPD-B、C、D三組的PCT水平不全相同,差異有統(tǒng)計學(xué)意義(P0.05),三組CRP水平差異無統(tǒng)計學(xué)意義(P0.05)。PCT:D組C組=B組,B組與C組PCT水平差異無統(tǒng)計學(xué)意義(P0.017),B組與D組,C組與D組PCT水平差異均有統(tǒng)計學(xué)意義(P0.017)。結(jié)論：1、PCT聯(lián)合WBC、N、CRP對AECOPD伴肺炎的診斷可能起輔助作用。2、PCT對AECOPD的住院時間、抗菌治療療程、住院費用可能有參考價值。3、PCT對AECOPD病情嚴重程度的評估可能有指導(dǎo)意義。
[Abstract]:Objective: to observe the changes and correlation of procalcitonin (PCT) C-reactive protein (CRP) in acute exacerbation of chronic obstructive pulmonary disease (COPD) and its value in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the severity of AECOPD and the diagnosis of AECOPD complicated with pneumonia. Methods: according to the design requirements, 219 COPD patients admitted to Department of Respiratory Medicine, first affiliated Hospital of Kunming Medical University from September 2013 to December 2014, were divided into two groups: AECOPD group (n = 106) and AECOPD with pneumonia group (n = 113). The AECOPD group was divided into three groups according to the Global Initiative for chronic obstructive Pulmonary Disease (for structural Lung Disease4, GOLDD) standard: AECOPD-B group (AECOPD-B group) and group C (group C). White blood cells (WBCs), neutrophiles (N) percentage, duration of stay, course of antimicrobial treatment, hospitalization cost, etc were measured and collected in AECOPD patients with pneumonia. The correlation between PCTU CRP and the above mentioned indexes was analyzed. Results the duration of hospitalization, the course of antimicrobial treatment, and the cost of hospitalization in the WBCCn with pneumonia group were significantly higher than those in the AECOPD group (P 0.05). There was no significant difference in CRP between the two groups. There was no significant difference between the two groups in terms of PCT, hospitalization time, antimicrobial treatment course. There was a positive correlation between the cost of hospitalization and WBCN, there was a positive correlation between CRP and WBCN, there was a positive correlation between CRP and WBCN, there was a positive correlation between CRP and WBCN, and there was a positive correlation between CRP and PCT, hospital stay time, antibacterial treatment course, and there was a positive correlation between CRP and WBCN. There was a positive correlation between PCT and WBC, N-, CRP in patients with pneumonia. There was a positive correlation between PCT and WBC, N-, CRP in patients with pneumonia. There was no correlation between PCT and duration of hospitalization, course of antimicrobial treatment, cost of hospitalization (P0.05), CRP and WBCNPCT, there was a positive correlation between CRP and WBCNPCT, and there was a positive correlation between CRP and duration of hospitalization, and there was a positive correlation between CRP and WBCNPCT, and there was a positive correlation between CRP and duration of hospitalization, and there was no correlation between CRP and WBCNPCT, and there was a positive correlation between CRP and WBCNPCT. In the course of antibacterial treatment, the PCT levels of the three groups were not all the same as those of the three groups (P0.05, P 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05, P < 0.05), There was no significant difference in the levels of CRP among the three groups. There was no significant difference in the levels of PCT between group C and group C, group B and group C; there was no significant difference in the levels of PCT between group B and group C; there was no significant difference in the levels of PCT between group C and group D in group B and group D. There were significant differences in the levels of PCT between group C and group D. Conclusion the ratio of 1 / 1 PCT combined with WBCfN / CRP may play an auxiliary role in the diagnosis of AECOPD with pneumonia. The duration of hospitalization, the course of antimicrobial therapy and the cost of hospitalization may be helpful to evaluate the severity of AECOPD. 3. [WT5 "HZ] [WT5" BZ] [WT5 "BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ]
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R563.9

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