Value Of Procalcitonin, C-reactive Protein In Exacerbations Of Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease areas facing many problemsin patients with chronic obstructive pulmonary disease is currently growing rapidlyworldwide mortality rate caused by high morbidity, the attention received by the diseaseitself, but not much. Acute exacerbation of COPD increased economic burden, moreimportantly, it accelerates the patient’s lung function decline, greatly reducing theirquality of life, increased mortality. Although a considerable part of the evidence thatpatients with acute exacerbation of chronic obstructive pulmonary disease pathogeninfection, but how fast and accurately determine the type of infection, antibiotics arestill reasonable guide lot of controversy. Procalcitonin and C-reactive protein hasemerged in recent years, the sensitivity of inflammatory markers, can be rapid, sensitiveand reflect the body’s inflammatory changes, as people gradually deepen theirunderstanding of these biomarkers may be able to which brings us to a betterunderstanding of the disease.Objective: Evaluation of procalcitonin (procalcitonin, PCT) and C-reactive protein(C-reactive protein) in patients with chronic obstructive pulmonary disease with acuteexacerbation (acute exacerbations of chronic obstructive pulmonary disease, AECOPD)the origin and cause of the value of the initial antibiotic treatment.Methods: This test method uses a case-control study from April2013to December2013in our hospital93cases of patients with COPD, including chronic obstructive pulmonary disease exacerbation group (n=50) and stable group (n=43). Acuteexacerbation of COPD and stable group were detected in serum PCT, CRP levels, bodytemperature, white blood cell count and classification (N%), record patient smokingstatus, comorbidities (heart failure, hypertension, diabetes, etc.), chronic obstructivepulmonary disease status, microorganisms in sputum culture，hospitalization, antibioticsfor a few days, FEV1%Pred, FEV1/FVC and other clinical data. This study usedSPSS19.0statistical software for statistical analysis, P <0.05was considered statisticallysignificant.Results:1.Acute exacerbation of COPD serum PCT concentration (0.34±0.53) ng/ml, stable serum PCT concentration (0.09±0.09) ng/ml difference was statisticallysignificant (P <0.05); acute exacerbation of chronic obstructive pulmonary diseaseserum CRP concentration (33.78±52.79) ng/ml, stable serum CRP concentration (3.58±3.10) ng/ml difference was statistically significant (P <0.05).2.Chronic obstructivepulmonary disease in patients with acute exacerbation of PCT and CRP was positivelycorrelated (r=0.63, P <0.05), and peripheral WBC, no correlation between length ofstay, and lower values PCT, CRP rises more meaningful.3. Anthonisen Ⅰ typeserum PCT concentration (0.36±0.73) ng/ml, type Ⅱ serum PCT concentration(0.20±0.08) ng/ml, Ⅲ type serum PCT concentration (0.21±0.15) ng/ml, eachgroup P>0.05, not statistically significant; Anthonisen Ⅰ type serum CRPconcentration (34.83±48.97) ng/ml, type ⅱ serum CRP concentration (25.31±0.73)ng/ml, Ⅲ type serum CRP concentration (22.96±40.46) ng/ml, each group P>0.05,not statistically significant.4.PCT combined with acute exacerbation of COPD CRPguide treatment group (A) and the conventional treatment group (group B) patients ingroup A and B patients in the conventional therapy group, the number of cases the useof antibiotics and the total number of days of hospitalization was no significantdifference, P>0.05; antibiotic use in patients in group A few days shorter than that ingroup B, the difference was statistically significant, the severity of P <0.05.5.age,gender, fever cases, smoking status, comorbidity, chronic obstructive pulmonary disease.and three months after the severity of chronic obstructive pulmonary disease during acute exacerbation group and the stable group was not statistically significant.However,the detection of microorganisms in sputum culture, acute exacerbation groupthan in the morestable group,the difference was statistically significant, P<0.05.Conclusion: PCT and CRP in the presence of bacterial infections associated withchronic obstructive pulmonary disease with acute exacerbation,and PCT and CRPmeasurements help to guide antibiotic treatment of acute exacerbation of chronicobstructive pulmonary disease.