摘要
目的探访慢性阻塞性肺疾病急性加重期及临床缓解期呼出气一氧化氮(FENO)和血降钙素原(PCT)的变化,指导慢阻肺患者急性发作期抗生素药物的使用。方法对2014年12月—2015年12月,在潍坊呼吸病医院呼吸与危重症医学科住院治疗的100例慢性阻塞性肺疾病急性加重期(AECOPD)患者,治疗前测定呼出气一氧化氮、血降钙素原,同时进行痰细菌培养,将咳黄脓痰者为(A组),咳白痰或者无痰者为(B组)。治疗后临床缓解期,再次进行FENO及PCT检测。结果治疗前,A组患者FENO与B组患者比较,FENO数值明显升高,差异有统计学意义(P <0.05);治疗后A组患者与B组患者FENO比较,FENO数值均明显下降,差异无统计学意义(P>0.05);治疗前后,A组患者两次FENO比较,FENO明显下降,差异有统计学意义(P <0.05);治疗前后,B组患者两次FENO比较,FENO明显下降,差异有统计学意义(P <0.05)。治疗前,A组患者血清PCT与B组患者比较,差异有统计学意义(P <0.05);治疗后A组患者血清PCT与B组患者比较,差异无统计学意义(P> 0.05);治疗前后,A组患者两次血清PCT比较,差异有统计学意义(P <0.05);治疗前后,B组患者两次血清PCT比较,差异有统计学意义(P <0.05)。结论 AECOPD患者感染的严重程度与其FENO及PCT水平有良好的相关性,检测FENO及PCT对于判断AECOPD患者急性加重及感染的严重程度,提高判断的准确性,指导临床治疗。
Objective To investigate the changes of exhaled nitric oxide(FENO)and procalcitonin(PCT)in patients with chronic obstructive pulmonary disease(COPD)during acute exacerbation and clinical remission,and to guide the use of antibiotics in patients with COPD during acute attack.Methods From December 2014 to December 2015,100 patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)were hospitalized in the Department of Respiratory and Critical Care Medicine of Weifang Respiratory Hospital.Exhaled nitric oxide and procalcitonin were measured before treatment,and sputum bacteria were cultured.The patients with yellow and purulent phlegm(group A)and those with white or no phlegm(group B).FENO and PCT were detected again in the remission period after treatment.Results Before treatment,the FENO value of group A was significantly higher than that of group B(P<0.05).After treatment,the FENO values of group A and group B decreased significantly,with no significant difference(P>0.05).Before and after treatment,FENO in group A decreased significantly compared with that in group A(P<0.05).Before and after treatment,FENO in group B decreased significantly compared with that in group B(P<0.05).Before treatment,there was a significant difference in serum PCT between group A and group B(P<0.05).There was no significant difference in serum PCT between group A and group B after treatment(P>0.05).Before and after treatment,there was significant difference in serum PCT between group A and group A(P<0.05).Before and after treatment,there was significant difference in serum PCT between two groups(P<0.05).Conclusion There is a good correlation between the severity of infection and the levels of FENO and PCT in AECOPD patients.Detection of FENO and PCT can judge the severity of acute exacerbation and infection in AECOPD patients,improve the accuracy of judgment and guide clinical treatment.
作者
于国华
曹琳娜
苏春芳
杨国儒
杜建新
YU Guohua;CAO Linna;SU Chunfang;YANG Guoru;DU Jianxin(Graduate School of Medical College,Qingdao University,QingdaoShandong 266000,China;Department of Respiratory and Critical Care Medicine,Weifang City Second People's Hospital (Weifang Respiratory Hospital),Weifang Shandong 261041,China;Department of Respiratory,Hainan Provincial Second People's Hospital,Wuzhishan Hainan 572200,China;Department of Respiratory and Critical Care Medicine,The Affiliated Hospital of Qingdao University,Qingdao Shandong 266000,China)
出处
《中国继续医学教育》
2019年第11期105-108,共4页
China Continuing Medical Education
基金
国家重点研发计划精准医学专项课题(2016YFC0901102)
关键词
慢性阻塞性肺疾病
细菌感染
呼出气一氧化氮
降钙素原
黄痰
抗生素
chronic obstructive pulmonary disease
bacterial infection
exhaled nitric oxide
procalcitonin
yellow sputum
antibiotics
