探讨降钙素原和D二聚体检测在慢性阻塞性肺疾病急性加重期呼吸道细菌感染中意义.docVIP

探讨降钙素原和D二聚体检测在慢性阻塞性肺疾病急性加重期呼吸道细菌感染中意义 　　作者单位：529100 广东省江门市南方医科大学附属新会医院 　　通讯作者：陈世豪 　　【摘要】 目的 探讨降钙素原（PCT）和D-二聚体（D-D）检测在诊断和治疗慢性阻塞性肺疾病加重期（AECOPD）的临床价值。方法 对85例AECOPD患者进行免疫色谱法检测降钙素原（PCT）和免疫比浊法定量检测D-二聚体（D-D），同时作支纤镜深部痰培养。结果 痰培养阳性组（62例）PCT阳性率和D-D水平明显高于痰培养阴性组（23例）（P0.01），而PCT梯度与D-D水平有正相关性。结论 降钙素原和D-二聚体可作为AECOPD细菌性感染危重程度的监控。PCT检测结果对患者细菌感染程度的诊断具有快速方便的优势，从而合理使用抗生素治疗；同时D-D检测水平反映AECOPD患者凝血功能状况，对指导抗凝药物治疗有重大意义。 　　【关键词】 降钙素原（PCT）； D-二聚体（D-D）； 慢性阻塞性肺疾病； 感染 　　Probing into the significance of level of serum procalcitonin and D-Dimer in respiratory tract infections of acute exacerbation of chronic obstructive pulmonary diseases CHEN Shi-hao, LIANG Jin-quan. Xinhui Hospital Affiliated to Southern Medical University, Jiangmen 529100, China 　　【Abstract】 Objective To evaluate the clinical value of procalcitonin（PCT） and D-Dimer（D-D） in the diagnosis and treatment in respiratory tract infections of acute exacerbation of chronic obstructive pulmonary diseases.Methods Solid-phase immune chromatography and immune nephelometry were used to detemine the levels of serum PCT and D-D in 85 AECOPD patients in respiratory department, meanwhile, sputum culture in the deep part of the lungs was sampled out by using bronchoscope.Results The positive rate of PCT and the level of D-D in sputum culture positive group（62 cases） was significantly higher than negative group（23 cases）（P0.01）, and there was a positive correlation between the level of PCT and D-D.Conclusion PCT and D-D are both important markers for severity monitor of respiratory tract infections in AECOPD. The advantage of PCT testing is that it can reflect the severity of bacterial infection quickly and conveniently, and make antibiotics used reasonable. The level of D-D reflect the severity of coagulation of AECOPD patients, it has great guiding significance to use anticoagulation drugs for treating. 　　【Key words】 Procalcitonin; D-Dimer; Chronic obstructive pulmonary diseases; Infection 　　 慢性阻塞性肺疾病（chronic obstructive pulmonary diseas