COPD患者呼出气冷凝液中炎的检测及其意义.DOC

CAP患者呼出气冷凝液中PCT检测的临床意义陈金亮 徐永谦 陶一江 陈建荣 【摘 要】目的 通过对社区获得性肺炎（CAP）患者呼出气冷凝液（EBC）中降钙素原(PCT)的检测，探讨其在CAP患者病情评估及疗效评价中的价值。方法 选择7例CAP住院患者，收集患者第1、3、7天的EBC及血清标本，并记录患者入院时白细胞计数、C反应蛋白（CRP）、CURB-65评分。选择健康体检者4例，收集其EBC及血清。结果 ①CAP患者EBC中PCT水平高于正常对照组，﹤0.0；②CAP患者第3天和第7天EBC中PCT水平下降，差异具有统计学意义（﹤0.0）；③EBC中PCT水平在高危组、中危组和低危组3组间的差异具有统计学意义(P＜001)；④EBC中PCT水平和血PCT、血CRP、WBC水平和CURB-65评分皆呈正相关结论 CAP患者EBC中PCT水平与患者病情严重程度具有较好的相关性，是判断CAP严重程度和预后的敏感指标。 【关键词】社区获得性肺炎；呼出气冷凝液；降钙素原；分临床意义The clinical significance of PCT in exhaled breath condensate of patients with community-acquired pneumonia.CHEN Jin-liang, XU Yong-qian，TAO Yi-jiang，CHEN Jian-rong. Department of Respiratory, Nantong First Peoples Hospital，Nantong 226001, China. 【Abstract】Objective To study the changes and clinic significances of procalcitonin (PCT) in exhaled breath condensate（EBC）in patients of community-acquired pneumonia (CAP). Methods We selected 7 cases of the CAP hospitalized patients, and according to CAP guidelines given regular treatment, collected their EBC samples in the 1,3,7 day, and recorded their leukocyte count, C-reactive protein(CRP) , CURB-65 score. We also selected 48 cases of the healthy examination people, collected their EBC and serum samples. Results①Compared with the healthy control group, the PCT levels in EBC were higher (P 0.01).②Compared with the first day, PCT levels in EBC were decreased in day 3 and day 7, the difference were statistically significant (P0.01).③The EBC level of PCT in high score group was higher than that in median score group and that in low score group，differences were statistically significant(P001)．④The EBC level of PCT had positive relationship with the CURB-65 score serum PCT, CRP and WBC, P＜0.01. Conclusions There is a good correlation between the EBC level of PCT and the severity of the disease，suggesting that PCT to be a sensitive predictor of severity and prognosis of the CAP．【Key words】ommunity-acquired pneumonia;exhaled breath condensate; procalcitonin; CURB-65 score; clinical significan