Abstract
Objective:To observe the changes in the levels of C-reactive protein (CRP) and procalcitonin (PCT) in serum of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and to compare with the values of CRP in combination with PCT in the diagnosis and treatment of infective exacerbation of COPD.Methods:One hundred and sixty-four patients who developed acute exacerbation of COPD and admitted to the Binzhou People’s Hospital from March 2014 to December 2015 were selected. They were divided into an infection group (N=98) and a non-infection group (N=66) according to bacterial culture results of sputum and lung computer tomography (CT) examination results. Moreover, 50 healthy people were selected as a normal control group. The levels of PCT and CRP of the three groups were determined respectively; patients in the infection group and non-infection group were determined again after administration of antibacterial drugs for a period of time. The results were all recorded.Results:The levels of PCT and CRP of the infection group were significantly higher than those of the non-infection group and the normal control group before treatment, and the difference had statistical significance (P<0.05). The levels of PCT and CRP were (1.97±0.13) μg/L and (7.34±2.66) mg/L respectively in the infection group after treatment, which was much lower than the levels before treatment (P<0.05). The level of PCT of the infection group was remarkably higher than that of the non-infection group after treatment (P<0.05), but the difference of CRP level between the infection group and non-infection group had no statistical significance (P>0.05). The specificity and sensitivity of diagnosing COPD in combination with bacterial infection with PCT or CRP were lower than those of PCT in combination with CRP.Conclusion:Levels of CRP in combination with PCT is a reliable index for determining the existence of bacterial infection, which is of great clinical guidance significance to the treatment and prognosis assessment of AECOPD patients.
Highlights
Chronic Obstructive Pulmonary Disease (COPD) is an incompletely reversible airflow obstruction induced chronic airway inflammation which develops progressively and mainly involves lung.[1,2] The symptoms of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) include cough, short of breath or aggravated wheeze, increased purulent or mucopurulent sputum, etc
The laboratory detection of infectious diseases mainly focused on white blood cell (WBC), erythrocyte sedimentation rate (ESR) and N which were the basis for the application of antibacterial drugs; but the indexes which are lack of specificity may result in misdiagnosis and missed diagnosis, leading to delayed treatment and increased mortality.[6]
All patients were diagnosed according to The Guidelines of the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease formulated by COPD team of Respiratory Disease Branch of Chinese Medical Association,[9] and all of them were at the stage of acute exacerbation, i.e., they had any two of the following symptoms: aggravated anhelation accompanied by gasp and chest distress; aggravated cough and increased purulent sputum; fever; rhonchi and wheezing rale; respiratory failure
Summary
Chronic Obstructive Pulmonary Disease (COPD) is an incompletely reversible airflow obstruction induced chronic airway inflammation which develops progressively and mainly involves lung.[1,2] The symptoms of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) include cough, short of breath or aggravated wheeze, increased purulent or mucopurulent sputum, etc. The laboratory detection of infectious diseases mainly focused on white blood cell (WBC), erythrocyte sedimentation rate (ESR) and N which were the basis for the application of antibacterial drugs; but the indexes which are lack of specificity may result in misdiagnosis and missed diagnosis, leading to delayed treatment and increased mortality.[6] C-reactive protein (CRP) and procalcitionin (PCT) are both the resistance products which are generated when pathogenic microorganism invades human body and stimulates cells. They have been the new cytokine indexes for diagnosing bacterial infection and have been gradually paid attention to.[7,8] Through observing the changes of PCT and CRP levels, this study investigated the values of them in the diagnosis and treatment of COPD in combination with bacterial infection
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