慢性阻塞性肺疾病患者急性加重期降钙素原与APACHEⅡ评分的相关性【摘要】目的探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者血清降钙素原（PCT）与急性生理学与慢性健康状况Ⅱ评分（APACHEⅡ）的相关性及对预后的影响。方法采用前瞻性设计，选取88例在北京大学第三医院急诊科住院的AECOPD患者，根据APACHEⅡ评分分为高危组、中危组和低危组，检测入院后24h内的PCT、超敏C反应蛋白（hs-CRP）、白细胞计数（WBC）和血乳酸，比较各组间的差异；研究PCT与APACHEⅡ、hs-CRP、WBC和血乳酸的相关性。根据预后将患者分为存活组与死亡组，比较两组间上述各指标的差异。结果高危组PCT为（0.60±0.32）ng/ml，高于中危组（0.36±0.23）ng/ml和低危组（0.24±0.19）ng/ml，PCT在3组间的差异具有统计学意义（P<0.01）。高危组hs-CRPM（P25，P75）为36.88（10.14，47.16）mg/L，高于中危组的15.00（3.64，30.33）mg/L和低危组的14.77（4.35，15.80）mg/L，hs-CRP在3组间的差异具有统计学意义（P=0.046）。PCT与APACHEⅡ评分和hs-CRP明显相关，差异具有统计学意义（P<0.01）。死亡组的PCT、APACHEⅡ评分、hs-CRP和乳酸均高于存活组，差异具有统计学意义（P<0.05）。结论AECOPD患者PCT与APACHEⅡ评分具有较好的相关性，是判断AECOPD预后的敏感指标。【关键词】慢性阻塞性肺病；降钙素原；急性生理学与慢性健康状况Ⅱ评分ThecorrelationbetweenserumprocalcitoninandacutephysiologyandchronichealthevaluationⅡ（APACHEⅡ）scoreinacuteexacerbationofchronicobstructivepulmonarydiseaseLIShuo，ZHENGYa-an.EmergencyDepartment，PekingUniversityThirdHospital，Bei激ng100191，ChinaCorrespondingauthor：ZhengYa-an，Email：z.y.a@medmail【Abstract】ObjectiveToinvestigatethecorrelationbetweenserumprocalcitonin（PCT）andacutephysiologyandchronichealthevaluationⅡ（APACHEⅡ）scoreandprognosisinacuteexacerbationofchronicobstructivepulmonarydisease（AECOPD）.MethodsAtotalof88patientswithAECOPDadmittedtoemergencydepartmentofPekinguniversitythirdhospitalwereprospectivelystudied，andweredividedintothreegroups，namelyhighscoregroup，medianscoregroupandlowscoregroupaccordingtoAPACHEⅡscore.SerumPCT，hypersensitiveC-reactiveprotein（hs-CRP），WBCandlactatewereassayedwithinthefirst24hoursafteradmission，thedifferencesinthoseindicatorsbetweenthreegroupswereanalyzed；andthecorrelationbetweenPCTandAPACHEⅡscore，hs-CRP，WBC，lactatewereinvestigated.Thepatientsweredividedintosurvivalgroupanddeathgroupaccordingtoprognosis，andthedifferencesinthoseindicatorsbetweenthetwogroupswereanalyzed.ResultsTheserumlevelsofPCTwashigherinhighscoregroup（0.60±0.32）ng/mlthanthatinmedianscoregroup（0.36±0.23）ng/mlandthatinlowscoregroup（0.24±0.19）ng/ml，differencesbetweengroupswerestatisticallysignificant（P<0.01）.Thehs-CRPwashigherinhighscoregroupM（P25，P75）36.88（10.14，47.16）mg/Lthanthatinmedianscoregroup15.00（3.64，30.33）mg/Landthatinlowscoregroup14.77（4.35，15.80）mg/L（P=0.046）.ThePCTsignificantlycorrelatedwithAPACHEⅡandhs-CRP（P<0.01）.TheserumlevelsofPCT，APACHEⅡscore，hs-CRPandlactateweresignificantlyhigherindeathgroupthanthoseinsurvivalgroup（P<0.05）.ConclusionsThereisagoodcorrelationbetweenPCTandAPACHEⅡscoreinpatientsofAECOPD，suggestingPCTtobeasensitivepredictorofprognosis.【Keywords】Chronicobstructivepulmonarydisease；Procalcitonin；AcutephysiologyandchronichealthevaluationⅡscore慢性阻塞性肺疾病（chronicobstructivepulmonarydisease，COPD）是一种以气流受限为特征的慢性气道炎症性疾病，发病率及病死率高。COPD急性加重期（acuteexacerbation，AECOPD）可导致肺功能的迅速恶化，住院治疗费用占整个疾病花费一半以上，给家庭和社会...