血清肝素结合蛋白联合可溶性髓样细胞触发受体1对慢性阻塞性肺疾病急性加重患者细菌感染的诊断效果  

Diagnosis efficiency of serum heparin-binding protein combined with soluble triggering receptor expresses on myeloid cells-1 level for bacterial infection in patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：郭昌鹏 王光艳 耿岩 李娜[4] Guo Changpeng;Wang Guangyan;Geng Yan;Li Na(Respiratory Medicine,the 971 Naval Hospital of PLA,Shandong Qingdao 266000,China;Respiratory Medicine,West District of Qingdao Municipal Hospital,Shandong Qingdao 266000,China;Respiratory Medicine,Qingdao Eighth People’s Hospital,Shandong Qingdao 266000,China;Department of Internal Medicine-Cardiovascular,West District of Qingdao Municipal Hospital,Shandong Qingdao 266000,China)

机构地区：[1]解放军海军第九七一医院呼吸内科,山东青岛266000 [2]山东省青岛市市立医院西院区呼吸内科,山东青岛266000 [3]山东省青岛市第八人民医院呼吸内科,山东青岛266000 [4]山东省青岛市市立医院西院区心血管内科,山东青岛266000

出　　处：《中国医刊》2021年第7期724-728,共5页Chinese Journal of Medicine

基　　金：山东省自然科学基金(ZR2017FM111)。

摘　　要：目的探讨血清肝素结合蛋白(heparin-binding protein,HBP)联合可溶性髓样细胞触发受体1(soluble triggering receptor expresses on myeloid cells-1,sTREM-1)对慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者细菌感染的诊断价值。方法选择2017年5月至2019年8月解放军海军第九七一医院收治的173例AECOPD患者,根据是否发生细菌感染分为感染组(105例)和未感染组(68例),另选择同期门诊体检中心健康体检者62例作为对照组。检测三组的血清HBP及sTREM-1水平,分析二者联合诊断AECOPD患者是否发生细菌感染的临床价值。结果感染组、未感染组白细胞计数、中性粒细胞百分比均高于对照组,且感染组高于未感染组,差异有显著性(P<0.05)。感染组慢性阻塞性肺疾病病程长于未感染组,合并糖尿病、近1年糖皮质激素使用≥3次、临床分级Ⅲ级、机械通气、中心静脉置管的比例均高于未感染组(P<0.05)。感染组、未感染组血清HBP、sTREM-1水平均高于对照组,且感染组高于未感染组,差异有显著性(P<0.05)。Logistic回归分析结果显示,近1年糖皮质激素使用次数≥3次、高水平血清HBP、sTREM-1是AECOPD细菌感染的危险因素(P<0.05),校正近1年糖皮质激素使用次数后,血清HBP、sTREM-1水平仍与AECOPD细菌感染的发生有关(P<0.05)。HBP、sTREM-1单独应用诊断AECOPD细菌感染的最佳截断值取39.56 ng/ml、89.65 pg/ml时,曲线下面积为0.762、0.757,HBP联合sTREM-1诊断AECOPD细菌感染的曲线下面积为0.905,高于单独应用HBP或sTREM-1时,差异有显著性(P<0.05)。结论AECOPD细菌感染者血清HBP、sTREM-1水平均升高,HBP联合sTREM-1诊断AECOPD细菌感染有较高的临床价值。Objective To investigate the value of serum heparin-binding protein(HBP)combined with soluble triggering receptor expresses on myeloid cells-1(sTREM-1)in the diagnosis of bacterial infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method A total of 173 AECOPD patients diagnosed and treated in The 971 Naval Hospital of PLA from May 2017 to August 2019 were selected.According to whether bacterial infection occurred,the patients were divided into infected group(105 cases)and uninfected group(68 cases).Another 62 healthy subjects were selected from the outpatient physical examination center as the control group.Serum HBP and sTREM-1 levels were detected to analyze the relationship between them and bacterial infection in AECOPD patients,and the value of HBP combined with sTREM-1 in the diagnosis of bacterial infection in patients with AECOPD were analyzed.Result The serum levels of HBP and sTREM-1 in the infected and uninfected groups were higher than those in the control group(P<0.05),and those in the uninfected group were higher than those in the control group(P<0.05).The duration of COPD in the infected group was longer than that in the uninfected group,and the proportions of diabetes mellitus,the use of glucocorticoids≥3 times in recent 1 year,clinical gradeⅢ,mechanical ventilation and central venous catheterization were higher than those in the uninfected group(P<0.05).Serum HBP and sTREM-1 levels in both infected and uninfected groups were higher than those in control group,and those in infected group were higher than those in uninfected group,the difference was significant(P<0.05).Logistic regression analysis showed that Frequency of glucocorticoid use≥3 times in recent 1 year,high level of HBP and sTREM-1 were risk factors for bacterial infection of AECOPD(P<0.05).After adjusting for the frequency of glucocorticoid use in the last 1 year,HBP and sTREM-1 were still associated with the occurrence of bacterial infection with AECOPD patients(P<0.05).When the optim

关 键 词：肝素结合蛋白 可溶性髓样细胞触发受体1 慢性阻塞性肺疾病急性加重 细菌感染 

分 类 号：R563[医药卫生—呼吸系统]