The Clinical Value Of Procalcitonin In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease(COPD)is a preventable and treateable disease.Chronic and progressive exacerbations of cough,sputum and dyspnea are typical symptoms.The acute exacerbation of chronic obstructive pulmonary disease causes the exacerbation of the respiratory symptoms,we need to change the conventional medication program.And each of the acute exacerbation of COPD will lead to a further decline in the patient’s lung function and affect the patient’s labor and quality of life.Infection is the main cause of acute exacerbation of COPD.And anti infection treatment is an important measure to control the acute exacerbation of patients.Procalcitonin as a marker of bacterial infection has been paid more and more attention.Objective:To analyze the changes of procalcitonin in healthy people,COPD patients and AECOPD patients,we make further effers to explore the clinical value of procalcitonin in AECOPD patients,providing the basis for timely diagnosis and treatment of patients with AECOPD Methods:75 patients with AECOPD were enrolled in the AECOPD group from September 2015 to December 2016 in the Department ofRespiratory Medicine,the First Hospital of Jilin University.According to the results of sputum culture,were divided into gram negative bacteria and gram positive bacteria group.75 cases of patients with COPD follow-up were COPD stable group.30 healthy subjects were selected as healthy controls.To analyze the serum procalcitonin and other inflammatory factors level in patients with AECOPD.Results:1.The levels of white blood cells,IL-6,TNF-α,C-reactive protein and procalcitonin in AECOPD group were significantly higher than those in healthy control and COPD groups(P <0.05).The level of IL-6 and TNF-α in COPD group was higher than that in healthy control group(P<0.05).There was no significant difference in white blood cells,C-reactive protein and procalcitonin between healthy control group and COPD group(P> 0.05).2.The positive rate of sputum culture in AECOPD group was higher than that in COPD group,the difference was statistically significant(P<0.05).3.The sensitivity of peripheral white blood cells,CRP,IL-6,TNF-αand PCT in group AECOPD was 50.7%,69.3%,74.7%,78.6%,respectively,and the specificity was 82.7%,77.3%,48%,44%,96% and64% respectively.The sensitivity and specificity of PCT positive diagnosis were higher than that of peripheral blood leucocytes,CRP,IL-6and TNF-α.4.The level of procalcitonin in gram negative bacteria was higher than gram positive bacteria,the difference was statistically significant(P <0.05).5.The level of procalcitonin in AECOPD patients with mechanical ventilation was higher than those without mechanical ventilation,the difference was statistically significant(P <0.05).Conclusion:1.AECOPD is mainly caused by infection.Procalcitonin is at a high level in the serum of patients with AECOPD,compared with other inflammatory markers with high specificity and sensitivity,and change is closely associated with the illness degree.It can be used as an indicator of bacterial infection and disease severity in patients with acute exacerbation of COPD.2.Procalcitonin is an indicator of AECOPD with bacterial infection.The difference of PCT between gram positive bacteria and gram negative bacteria is obvious.It can be used as a basis for the identification of gram positive bacteria and gram negative bacteria infection,and can provide a certain clinical basis for clinicians to select antibiotics.