CAJ | 학술논문

目的研究外周血粒细胞、单核细胞CD64表达在老年慢性阻塞性肺病(COPD)急性发作期患者细菌感染诊断中的价值.方法选取2010年9月至2012年1月江苏省泰州市人民医院COPD急性发作期老年患者47例,根据痰微生物检查结果分为细菌感染组(27例)和非感染组(20例),另外选择22名同期体检老年人作为健康对照组.采用流式细胞术检测所有研究对象外周血粒细胞、单核细胞CD64的表达,并观察其与C-反应蛋白(CRP)、粒细胞的关系.正态分布的资料采用方差分析,非正态分布的资料采用非参数检验.结果 COPD急性期细菌感染组患者粒细胞、单核细胞CD64表达和血浆CRP水平明显高于非细菌感染组(Q=3.451,4.323和4.077,P值均＜0.05)和健康对照组(Q=4.983,4.611和7.069,P值均＜0.05);而非细菌感染组只有CRP水平高于健康对照组(Q =2.678,P＜0.05).COPD急性发作期患者粒细胞、单核细胞CD64表达与粒细胞比例、CRP呈正相关(r=0.456,0.502和0.457,0.579,P值均＜0.01).CRP、单核细胞CD64表达和粒细胞CD64表达诊断COPD急性发作期细菌感染曲线下面积分别为0.949,0.869和0.826.结论老年COPD急性发作期患者外周血粒细胞、单核细胞CD64的表达明显增高,与炎症常用指标中性粒细胞比例和CRP关系密切,但敏感性较血浆CRP水平低.
목적 연구외주혈립세포、단핵세포CD64표체재노년만성조새성폐병(COPD)급성발작기환자세균감염진단중적개치.방법 선취2010년9월지2012년1월강소성태주시인민의원COPD급성발작기노년환자47례,근거담미생물검사결과분위세균감염조(27례)화비감염조(20례),령외선택22명동기체검노년인작위건강대조조.채용류식세포술검측소유연구대상외주혈립세포、단핵세포CD64적표체,병관찰기여C-반응단백(CRP)、립세포적관계.정태분포적자료채용방차분석,비정태분포적자료채용비삼수검험.결과 COPD급성기세균감염조환자립세포、단핵세포CD64표체화혈장CRP수평명현고우비세균감염조(Q=3.451,4.323화4.077,P치균＜0.05)화건강대조조(Q=4.983,4.611화7.069,P치균＜0.05);이비세균감염조지유CRP수평고우건강대조조(Q =2.678,P＜0.05).COPD급성발작기환자립세포、단핵세포CD64표체여립세포비례、CRP정정상관(r=0.456,0.502화0.457,0.579,P치균＜0.01).CRP、단핵세포CD64표체화립세포CD64표체진단COPD급성발작기세균감염곡선하면적분별위0.949,0.869화0.826.결론 노년COPD급성발작기환자외주혈립세포、단핵세포CD64적표체명현증고,여염증상용지표중성립세포비례화CRP관계밀절,단민감성교혈장CRP수평저.
Objective To evaluate the clinical value of CD64 expressions on peripheral granulocytes and monocytes during acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) in elderly patients with bacterial infections.Methods A total of 47 aged AE-COPD patients admitted in Taizhou People' s Hospital during September 2010 and January 2012 were recruited in the study,including 27 with bacterial infection and 20 without bacterial infection according to sputum microbiological examination; and 22 healthy controls were also enrolled.CD64 expressions on peripheral granulocytes and monocytes were detected by flow cytometry,and their correlations with C-reaction protein (CRP) and neutrophil percentage were analyzed.Analysis of variance was performed for normally distributed data,and non-parametric test was used for non-normally distributed data.Results The expressions of CD64 on granulocytes and monocytes and CRP level in the bacterial infection group were significantly higher than those in the non-bacterial infection group (Q =3.451,4.323 and 4.077,P ＜ 0.05) and the control group (Q =4.983,4.611 and 7.069,P ＜0.05).The CRP level in the non-bacterial infection group was higher than that in health controls (Q =2.678,P ＜ 0.05).CD64 expressions on granulocytes and monocytes were positively correlated with neutrophil percentage and CRP in AE-COPD (r =0.456,0.502 and 0.457,0.579,P ＜0.01).The areas under the receiver operating characteristic curves (AUC) of CRP and CD64 on granulocytes and monocytes for bacterial infections in AE-COPD were 0.949,0.869 and 0.826.Conclusions The expressions of CD64 on peripheral granulocytes and monocytes are increased in the aged patients with AE-COPD,which are closely correlated with neutrophil percentage and CRP levels.