LPS、PCT与PDGF联合检测对COPD急性期合并下呼吸道感染的诊断价值  

Diagnostic value of combined detection of LPS,PCT and PDGF in the acute phase of COPD complicated with lower respiratory tract infection

作　　者：王嘉妮 周忻 任传路 唐敏 褚丽 吴薇 WANG Jiani;ZHOU Xin;REN Chuanlu;TANG Min;CHU Li;WU Wei(Laboratory Department,the 904th Hospital of Joint Logistic Support Force,Wuxi Jiangsu 215000,China)

机构地区：[1]联勤保障部队第九〇四医院检验科,江苏无锡215000 [2]联勤保障部队第九〇四医院检验输血科,江苏无锡215000 [3]联勤保障部队第九〇四医院呼吸内科,江苏无锡215000

出　　处：《中国急救复苏与灾害医学杂志》2024年第3期336-339,345,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省自然科学基金青年基金项目(编号:BK20210072)。

摘　　要：目的探讨血清内毒素(LPS)、降钙素原(PCT)与血小板衍生生长因子(PDGF)联合检测对慢性阻塞性肺疾病急性期(AECOPD)合并下呼吸道感染的诊断价值。方法选取2021年1月—2022年12月期间联勤保障部队第九〇四医院收治的147例AECOPD患者为观察对象。统计AECOPD患者合并下呼吸道感染情况,并依据是否合并下呼吸道感染分为发生组和未发生组。对比发生组和未发生组患者的临床资料。Logistic多因素回归分析影响AECOPD患者合并下呼吸道感染的危险因素。制作受试者工作特征曲(ROC),以曲线下面积(AUC)分析血清LPS、PCT及PDGF三者联合对AECOPD患者合并下呼吸道感染的诊断价值。结果AECOPD患者合并下呼吸道感染发生率为21.09%。发生组肿瘤坏死因子-α、白细胞介素-6、干扰素-γ、C反应蛋白(CRP)、血清LPS、PCT及PDGF水平均高于未发生组(P<0.05),IgG则低于未发生组(P<0.05)。Logistic多因素分析显示,白细胞介素-6(CI:2.898,95%CI:1.076~4.185)、LPS(CI:3.725,95%CI:2.729~10.354)、PCT(OR:3.089,95%CI:1.762~6.435)、PDGF(CI:3.330,95%CI:2.187~8.496)水平均是影响AECOPD患者合并下呼吸道感染发生的危险因素(P<0.05)。ROC曲线分析结果显示,血清LPS、PCT及PDGF三者联合对AECOPD患者合并下呼吸道感染诊断的灵敏度分别为77.42%(95%CI:58.46~89.72)、67.74%(95%CI:48.53~82.68)、70.97%(95%CI:51.76~85.11)、67.74%(95%CI:48.53~82.68),特异度分别为77.59%(95%CI:68.72~84.59)、75.00%(95%CI:65.95~82.37)、75.86%(95%CI:66.87~83.11)、98.28%(95%CI:93.30~99.71),AUC分别为0.715(95%CI:0.635~0.787)、0.820(95%CI:0.748~0.878)、0.723(95%CI:0.643~0.793)、0.902(95%CI:0.842~0.945)。结论血清LPS、PCT及PDGF三者联合检测对AECOPD合并下呼吸道感染的诊断效能较高。Objective To investigate the value of combined detection of serum endotoxin(LPS),procalcitonin(PCT)and platelet-derived growth factor(PDGF)in patients with acute phase of chronic obstructive pulmonary disease(AECOPD)complicated with lower respiratory tract infection.Methods A total of 147 AECOPD patients who admitted to 904th Hospital of Joint Logistic Support Force from January 2021 to December 2022 conducted to this study.AECOPD patients were divided into two groups:the occurrence group and the non-occurrence group according to whether lower respiratory tract infection occurred after 7 days of hospitalization.Logistic multivariate regression analysis on the risk factors of lower respiratory tract infection in AECOPD patients.The receiver operating characteristic curve(ROC)was prepared,and the area under the curve(AUC)was used to analyze the diagnostic value of serum LPS,PCT and PDGF combined with lower respiratory tract infectionin AECOPD patients.Results The occurrence group was 31cases(21.09%).The levels of tumor necrosis factor-α,interleukin-6,interferon-γ,C-reactive protein(CRP),serum LPS,PCT and PDGF in the occurrence group were higher than those in the non-occurrence group(P<0.05),while IgG was lower than that in the non-occurrence group(P<0.05).Logistic multivariate analysis showed that interleukin-6(OR:2.898,95%CI:1.076-4.185),LPS(OR:3.725,95%CI:2.729-10.354),PCT(OR:3.089,95%CI:1.762-6.435)and PDGF(OR:3.330,95%CI:2.187-8.496)were the risk factors for the occurrence of lower respiratory tract infection in AECOPD patients(P<0.05).The results of ROC curve analysis showed that the sensitivity of serum LPS,PCT and PDGF,and combination of threefor the diagnosis of lower respiratory tract infection in AECOPD patients was 77.42%(95%CI:58.46-89.72);67.74%(95%CI:48.53-82.68);70.97%(95%CI:51.76~85.11);and 67.74%(95%CI:48.53-82.68)respectively.The specificity was 77.59%(95%CI:68.72-84.59);75.00%(95%CI:65.95-82.37);75.86%(95%CI:66.87-83.11);and 98.28%(95%CI:93.30-99.71)respectively.AUC were 0.715(95%CI:0.635-0.787

关 键 词：慢性阻塞性肺疾病急性期 下呼吸道感染 血清内毒素 降钙素原 血小板衍生生长因子 诊断 

分 类 号：R563[医药卫生—呼吸系统]