外周血CD64水平变化和重症COPD肺部感染患者预后的关系研究  

Relationship between the change of peripheral blood CD64 level and the prognosis of patients with severe COPD pulmonary infection

作　　者：鲍晓芳 李哲钊 BAO Xiaofang;LI Zhezhao(Department of Respiratory and Critical Care,Anqing First People's Hospital,Anqing,Anhui 246000,China)

机构地区：[1]安庆市第一人民医院呼吸与危重症学科,安徽安庆246000

出　　处：《国际检验医学杂志》2024年第19期2334-2339,共6页International Journal of Laboratory Medicine

摘　　要：目的探讨外周血单核细胞簇分化抗原64(CD64)水平变化与重症慢性阻塞性肺疾病(COPD)肺部感染患者预后的关系。方法选取2019年1月至2022年12月于该院进行治疗的重症COPD肺部感染患者120例为研究对象。依据重症COPD肺部感染患者预后情况,将其分为死亡组(48例)和存活组(72例)。采用多因素Logistic回归模型分析CD64水平和重症COPD肺部感染患者死亡的关系,限制性立方样条模型分析CD64与COPD肺部感染患者死亡风险的剂量-反应关系,LASSO及多因素Logistic回归分析重症COPD肺部感染患者死亡发生的危险因素,列线图构建重症COPD肺部感染患者死亡的预测模型并进行验证。结果校正混杂因素后,CD64与COPD肺部感染患者死亡有关。限制性立方样条模型分析显示,CD64与COPD肺部感染患者死亡事件关联强度均不存在非线性剂量-反应关系,且和性别无关。多因素Logistic分析结果显示,吸烟史、糖尿病、白蛋白、CD64、白细胞介素-6、第1秒用力呼气容积/用力肺活量、第1秒用力呼气容积占预计值百分比是COPD肺部感染患者死亡事件的重要影响因素。训练集、验证集校准曲线和理想曲线的拟合度良好,受试者工作特征曲线的曲线下面积(95%CI)分别为0.809(95%CI 0.735~0.884)、0.798(95%CI 0.733~0.876),决策曲线净获益值较高。结论CD64与重症COPD患者肺部感染死亡有关,有望成为临床重症COPD肺部感染患者死亡发生事件的标志物。Objective To investigate the relationship between peripheral blood mononuclear cell membrane type cluster differentiation antigen 64(CD64)level and the prognosis of patients with severe chronic obstructive pulmonary disease(COPD)with pulmonary infection.Methods A total of 120 patients with severe COPD pulmonary infection who were treated in this hospital from January 2019 to December 2022 were selected as the research objects.According to the prognosis of patients with severe COPD pulmonary infection,they were divided into death group(48 cases)and survival group(72 cases).Multivariate Logistic regression model was used to analyze the relationship between CD64 levels and the risk of death in patients with severe COPD pulmonary infection.Restricted cubic spline model was used to analyze the dose-response relationship between CD64 and the risk of death in patients with severe COPD pulmonary infection.LASSO and multivariate Logistic regression were used to analyze the risk factors for death in patients with severe COPD and pulmonary infection.The nomogram was used to construct and verify the prediction model for death in patients with severe COPD and pulmonary infection.Results After adjusting for confounding factors,CD64 was associated with the mortality of COPD patients with pulmonary infection.Restricted cubic spline model analysis showed that there was no nonlinear dose-response relationship between CD64 and death events in COPD patients with pulmonary infection,and it was independent of gender.The results of multivariate Logistic analysis showed that smoking history,diabetes,albumin,CD64,interleukin-6,forced expiratory volume in one second/forced vital capacity,forced expiratory volume in one second percentage of predicted value were the important influencing factors of death events in COPD patients with pulmonary infection.The calibration curve and ideal curve of the training set and the validation set were well fitted.The area under the receiver operating characteristic curve(95%CI)was 0.809(95%CI 0.735-0.884)

关 键 词：慢性阻塞性肺疾病 肺部感染 簇分化抗原64 

分 类 号：R563.9[医药卫生—呼吸系统]