慢性阻塞性肺疾病急性加重期红细胞免疫和降钙素原相关性研究

Correlation between erythrocyte innate immune function and procalcitonin in AECOPD patients

目的观察慢性阻塞性肺疾病急性加重期(AECOPD)红细胞免疫功能及血清降钙素原(PCT)变化,并观察在抗感染治疗前后两者变化及相关性。方法采用郭峰法和化学发光法测定50例AECOPD患者和40例健康对照者外周血C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR)及血清降钙素原(PCT)水平及抗感染治疗前后的动态变化。结果AECOPD组治疗前RBC-C3bRR[(11.21±2.67)%]明显低于治疗后[(13.36±2.75)%]及健康对照组[(15.36±3.02)%],差异有统计学意义(P均<0.01)。AECOPD组治疗前RBC-ICR、PCT[(9.05±2.39)%,(0.29±0.15)ng/ml]明显高于治疗后[(7.95±1.55)%,(0.09±0.03)ng/ml]及健康对照组[(5.89±1.82)%,(0.08±0.05)ng/ml],差异有统计学意义(P均<0.01)。AECOPD患者组PCT水平与RBC-C3bRR呈显著负相关(r=-0.421,P<0.01),与RBC-ICR呈显著正相关(r=0.488,P<0.01)。结论 PCT是早期诊断AECOPD的敏感和有价值的指标,且AECOPD患者存在红细胞免疫功能的下降,可能是临床症状反复发作的原因。

Objective To observe the changes of erythrocyte innate immune function and procalcitonin （PCT）levels in elderly patients with AECOPD.Methods The rosette rate of red-cell C3b receptors （RBC-C3bRR）,red-cell immune complex （RBC-ICR）and serum PCT in the fresh peripheral blood were detected in 50 pa-tients with AECOPD and 40 healthy controls by Guo-Feng method and chemoluminescence respectively.Results The rosette rate of RBC-C3bRR was （1 1.21 ±2.67）%in AECOPD patients before the treatment,which was signifi-cantly lower than that of AECOPD patients after the treatment （1 3.36 ±2.75%）and the healthy controls （1 5.36 ± 3.02%）（P〈0.01 ）.The levels of RBC-ICR and PCT were （9.05 ±2.39）%and （0.29 ±0.1 5）ng/ml in AECO-PD patients before the treatment,which were obviously higher that those of patients with AECOPD after the treatment （7.95 ±1.55%）and （0.09 ±0.03）ng/ml and （5.89 ±1.82）%and （0.08 ±0.05）ng/ml in the control group （P〈0.01 ）.Correlation analysis of PCT and RBC-C3bRR in AECOPD patients revealed a significant negative correla-tion （r=-0.421 ,P〈0.01 ）,and PCT and RBC-ICR showed a significant positive correlation （r=0.488,P〈0.01 ）.Conclusion Serum PCT is a valuable and sensitive indicator for early diagnosis of AECOPD.AECOPD pa-tients has obvious suppression of erythrocyte innate immune function,which may cause the recurrence of AECOPD.