外周血白细胞CD64和CD11b指数在老年慢性阻塞性肺疾病急性期的早期诊断价值  

Early diagnostic values of CD64 and CD11b indices of peripheral white blood cells for acute exacerbation of chronic obstructive pulmonary disease in older adults

作　　者：毛卫未[1] 江永青[1] 欧阳良良[1] 王文娟[1] 吴蔚[2] 

机构地区：[1]九江学院附属医院检验科,江西九江332000 [2]九江学院附属医院呼吸科,江西九江332000

出　　处：《细胞与分子免疫学杂志》2014年第11期1201-1204,共4页Chinese Journal of Cellular and Molecular Immunology

摘　　要：目的探讨外周血白细胞CD11b指数、CD64指数在老年慢性阻塞性肺疾病(COPD)急性加重期患者的早期诊断价值。方法收集2011-03/2013-12期间九江学院附属医院入院就诊的稳定期COPD患者82例(稳定组),急性期COPD患者86例(加重组)及84例健康志愿者(对照组)。各组分别检测血常规、超敏C反应蛋白(hs-CRP),流式细胞术检测外周血白细胞CD64及CD11b的平均荧光强度(MFI),并换算成CD64指数和CD11b指数。筛选出诊断COPD急性加重期有差异的指标,绘制受试者工作特征(ROC)曲线,进行曲线下面积、临界值、灵敏度及特异性比较。结果与稳定期相比,老年COPD急性加重期CD11b指数降低和CD64指数升高,差异具有统计学意义(P<0.01),但老年COPD稳定组与健康对照组差异无统计学意义(P>0.05)。以CD11b指数<0.94、CD64指数>1.83为临界值阳性标准,其诊断COPD急性加重期的敏感度分别为62.65%和77.11%,特异性分别为79.52%和98.80%。结论外周血白细胞CD11b指数降低和CD64指数升高可作为早期诊断老年COPD急性加重的实验室依据,动态观察其水平变化,对评价治疗效果有一定价值。Objective To investigate the values of CD64 and CD11 b indices of peripheral white blood cells in the early diagnosis of acute exacerbation of chronic obstructive pulmonary disease（ AE-COPD） in older adults. Methods The study enrolled 86 aged AE-COPD patients,82 stable-COPD patients admitted in the affiliated hospital of Jiujiang University from March 2011 to December 2013,and simultaneously 84 healthy aged volunteers as a control group. All the subjects were examined in white blood cells,hypersensitive C-reactive protein（ hs-CRP）,mean fluorescence intensity（ MFI） of CD64 and CD11 b from peripheral white blood cells within 24 hours after admission. CD64 and CD11 b MFI were converted into CD64 and CD11 b indices by conversion formula. The significant indicators for the diagnosis of AE-COPD were screened and the receiver operating characteristic（ ROC） curve was drawn for calculating the area under the curve,critical value,sensitivity and specificity. Results Compare with stable-COPD group,the CD11 b index decreased and CD64 index increased. There existed statistical difference in CD11 b and CD64 indices between the AE-COPD group and the stable-COPD group（ P〈0.01）,but not between the stable-COPD group and the healthy control group（ P〉0.05）. Critical values of CD11 b and CD64 indices were respectively less than 0. 94 and more than 1. 83. Their sensitively and specificity for the diagnosis of AE-COPD were 62. 65% and 77. 11% for CD11 b and 79. 52% and 98. 80% for CD64. Conclusion Increased CD64 index and decreased CD11 b index are the credible laboratory markers in the early diagnosis of AE-COPD,and the dynamic monitoring of them may facilitate the evaluation of therapeutic outcomes of AE-COPD.

关 键 词：COPD CD64 CD11B ROC曲线 

分 类 号：R557[医药卫生—血液循环系统疾病]