外周血粒细胞、单核细胞CD64表达在老年慢性阻塞性肺病急性发作期细菌感染的诊断价值  

CD64 expression on peripheral granulocytes and monocytes during acute exacerbation of chronic obstructive pulmonary diseases in elderly patients with bacterial infection

作　　者：张立新[1] 叶军[1] 陈亚宝[2] 彭海林[2] 陈秀[2] 刘玲[2] 江爱桂[3] 黄俊星[1] 

机构地区：[1]江苏省泰州市人民医院临床医学研究所,225300 [2]江苏省泰州市人民医院检验科,225300 [3]江苏省泰州市人民医院呼吸科,225300

出　　处：《中华临床感染病杂志》2013年第5期287-291,共5页Chinese Journal of Clinical Infectious Diseases

基　　金：江苏大学2012年度医学临床科技发展基金

摘　　要：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。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.

关 键 词：肺疾病 慢性阻塞性 细菌感染 受体 IgG 粒细胞 单核细胞 

分 类 号：R563.9[医药卫生—呼吸系统]