老年肺部感染炎症指标的变化特征及其临床意义

Changes and Clinical Significance of Inflammatory Markers in Elderly Patients with Pulmonary Infection

中文关键词: 老年  肺部感染  炎症指标  诊断  临床意义

英文关键词: elderly  pulmonary infection  inflammatory marker  diagnosis  clinical significance

中文摘要:

      目的 观察老年肺部感染时C-反应蛋白(CRP)、白细胞计数(WBC)和红细胞沉降率(ESR)3种不同炎症指标的变化特征,为明确这些炎症指标作为肺部感染诊断和疗效评价指标提供依据.方法 选取江苏省盐城市第一人民医院2015年1月-2017年1月收治的40例老年肺部感染患者作为观察组,另选取同期来江苏省盐城市第一人民医院接受体检的40例健康人为对照组,观察组又分慢性阻塞性肺疾病急性发作期亚组(AECOPD亚组)(n=20)和社区获得性肺炎亚组(CAP亚组)(n=20).于治疗前、治疗3d、1周和2周后各时间点对各组CRP、WBC和ESR水平进行评估,并进行统计学分析与比较.结果 观察组中AECOPD亚组和CAP亚组的CRP、WBC和ESR水平均显著高于对照组(均P＜0.05).与治疗前比较,治疗3d、1周和2周后AECOPD亚组和CAP亚组的CRP水平逐渐降低,3个时间点之间的差异均有统计学意义(均P＜0.05);治疗3d、1周和2周后AECOPD亚组和CAP亚组的WBC水平虽逐渐减低,但这3个时间点之间的差异均无统计学意义(均P＞0.05);治疗3d、1周和2周后AECOPD亚组和CAP亚组ESR水平显著低于治疗前(均P＜0.05),治疗3d后与治疗后1周的ESR水平之间的差异无统计学意义(P＞0.05).结论 综合检测CRP、WBC和ESR的变化能反应肺部感染的发生,而与WBC和ESR相比,CRP作为老年肺部感染肺部诊断和疗效评价指标可能更灵敏和更准确.

英文摘要:

      Objective To observe the characteristics of change of C-reactive protein (CRP),white blood cell count (WBC) and erythrocyte sedimentation rate (ESR) in elderly patients with pulmonary infection so as to provide basis for these inflammatory markers as indicators in diagnosis and curative effect evaluation of pulmonary infection.Methods 40 elderly with pulmonary infection hospitalized during the period from Jan.,2015 to Jan.,2017 were enrolled to be observation group while 40 norm of physical examination during the same period were selected to be control group;observation group was further divided into 2 subgroups:AECOPD subgroup (acute exacerbation of chronic obstructive pulmonary disease) and CPA subgroup (community-acquired pneumonia),20 in each;the levels ofCRP,WBC and ESR of the patients in each group at the time point of before treatment,3 days,1 week and 2 weeks after treatment were observed and statistical anlysis and com parison were performed.Results The levels of CRP,WBC and ESR of the patients in AECOPD subgroup and CAP subgroup were much higher than those of the patients in control group (P＜0.05);the CRP levels of the patients in the 2 subgroups at each time point kept dropping down and were lower than those before treatment,and difference among the 3 time points after treatment was of statistical significance (P＜0.05);the WBCP levels of the patients in the 2 subgroups at each time point kept dropping down and were lower than those before treatment while the difference among the 3 time points after treatment was of no statistical significance (P＜0.05);the ESR levels of the patients in the 2 subgroups at each time point after treatment were much lower than that before treatment (P＜0.05) and there existed no difference of statistical significance between the level at the time point of 3 days after treatment and that at the time point of 1 week after treatment (P ＞ 0.05).Conclusions Combined detection of the changes in CRP,WBC and ESR can reflect the occurrence of pulmonary infection;CRP is more sensitive and more accurate in the diagnosis and curative effect evaluation of pulmonary infection in the elderly than WBC and ESR.