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目的 探讨老年COPD急性加重期胸片、痰细菌学与C -反应蛋白 (CRP)的相互关系。方法 利用免疫化学方法快速定量测定 47例高龄老年COPD急性加重期患者的血清CRP ,并行X线胸片检测和痰细菌培养。结果 47例患者中胸片示肺炎占 5 7.5 %。肺纹理增多者占 42 .5 %。 6 6 .0 %伴有发热 (31例 )。按CRP值高低将患者分成 3组 ,A组 :CRP <8mg/L ,B组 :CRP 9～ 39mg/L ,C组 :CRP >40mg/L。C组中肺炎的例数明显多于A组和B组 ,分别为 2 1、3和 3例 (P <0 .0 5 )。C组和B组的发热例数明显高于A组 ,分别为 2 4、6和 1例 (P <0 .0 1)。 2 7例痰培养出致病菌 ,阳性分离率为 5 7.5 % (2 7/ 47)。A、B、C3组 ,痰菌阳性分离率分别为14.3 %、5 4.6 %和 72 .4% ,各组之间的差异有显著性 (P <0 .0 5 )。结论 CRP的升高与肺炎的发生率、发热的例数、致病菌株数的检出率呈正相关 (分别为P <0 .0 5 ,P <0 .0 1,P <0 .0 5 )。证实CRP与感染严重程度呈正相关 ,与致病菌感染显著相关
Objective To investigate the relationship between the bacteriostasis of sputum and C - reactive protein (CRP) in elderly patients with acute exacerbation of COPD. Methods The serum levels of CRP in 47 elderly patients with acute exacerbation of COPD were measured by immunochemical methods and detected by X-ray and sputum bacterial culture. Results Of the 47 patients, chest radiograph showed pneumonia accounting for 7.57%. Lung texture increase accounted for 42.5%. 6 6 .0% with fever (31 cases). The patients were divided into three groups according to the level of CRP: group A: CRP <8 mg / L; group B: CRP 9-39 mg / L; group C: CRP> 40 mg / L. The number of cases of pneumonia in group C was significantly more than those in groups A and B, which were 2, 1, 3 and 3, respectively (P <0.05). The incidence of fever in group C and group B was significantly higher than that in group A, which was 24,6 and 1, respectively (P <0.01). Twenty-seven cases of sputum were cultured for pathogens, the positive rate was 57.5% (27/47). The positive rates of sputum in the groups A, B and C3 were 14.3%, 54.6% and 72.4%, respectively. The differences among the groups were significant (P <0.05). Conclusions The increase of CRP is positively correlated with the incidence of pneumonia, the number of fever and the detection rate of pathogenic bacteria (P <0.05, P <0.01, P <0.05) . Confirmed that CRP was positively correlated with the severity of infection and was significantly associated with pathogen infection