Study On The Relationship Between Sputum Bacteriology And HsCRP Level In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: To investigate the relationship between sputum bacteriology and hs CPR level in acute exacerbation of chronic obstructive pulmonary disease(COPD)by detecting the serum level and sputum bacteriology before and after therapy.Methods: 80 patients with acute exacerbation of COPD who were treated in Yijishan Hospital from October 2015 to October 2016 were selected as the observation group.80 health people were selected as the control group.The sputum bacteriology culture and strains identification,the detection of serum hs CRP,peripheral white blood cell count and neutrophil ration were performed respectively before and after treatment.Results:(1)The serum hs CRP level in observation group and control group were(60.87±52.12)mg/L and(5.63±3.12)mg/L,the differences were statistically significant(P<0.05).The peripheral white blood cell count and neutrophil ration were(10.13±4.47)×109/L and(78.46±14.21)% in observation group,and(6.25±1.39)×109/L and(51.33±9.61)% control group.The differences between the two groups were statistically significant(P<0.05).(2)The diagnostic sensitivity of serum hs CRP level,peripheral white blood cell count and neutrophil ration in patients with acute exacerbation of COPD were 82.50%?46.25% and 55.00%,respectively,which indicated that compared with peripheral white blood cell count and neutrophil ration,the diagnostic sensitivity of serum hs CRP level was higher.And the difference was statistically significant(P<0.05).(3)(34±6)strains Gram-negative bacteria(G-bacteria)and(16±5)strains Gram-positive bacteria(G+bacteria)were cultured in observation group,and(3±1)strains G-bacteria and(2±1)strains G+bacteria were cultured in control group.The differences between the two groups were statistically significant(P<0.05).(4)After treatment with antibiotics in acute exacerbation COPD patients,the level of serum hs CRP was(25.37±16.58)mg/L,and the cultured sputum G-bacteria and G+bacteria were(9±5)strains,respectively.Compared with before treatment,the differences were statistically significant(P<0.05).(5)The level of serum hs CRP and culture situation of sputum bacteria in acute exacerbation COPD patients were used to draw the receiver operating characteristic curve(ROC).The area under the ROC curve was calculated.It suggested that when the serum hs CRP level exceeded 28.65 mg/L,the acute exacerbation COPD patient was infected with bacteria.And the higher of the serum hs CRP level,the more serious of the bacterial infection.Conclusion:(1)Serum hs CRP level can be used as a diagnostic index for patients with acute exacerbation of COPD,and its diagnostic sensitivity is higher than the peripheral white blood cell count and neutrophil ratio.(2)Serum hs CRP level can provide the evaluated evidence of clinical efficacy in acute exacerbation of COPD patients.(3)Serum hs CRP can be involved in the severe process of acute exacerbation of COPD,which can reflect the bacterial infection situation and can be used as an indicator of bacterial infection in acute exacerbation of COPD patients.