慢性阻塞性肺疾病急性加重期HBP与CD64的表达及意义

Expression and significance of HBP and CD64 in acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者中性粒细胞CD64与肝素结合蛋白(HBP)的表达及意义。方法收集2013年7月至2014年11月该院慢性阻塞性肺疾病(COPD)患者200例作为研究对象,其中COPD稳定期100例,AECOPD 100例。使用流式细胞术及免疫荧光法测定CD64,酶联免疫吸附试验测定HBP,同时检测血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)及白细胞计数(WBC),评价HBP与CD64对AECOPD的诊断价值。AECOPD患者同时送检痰液进行细菌培养,送检鼻拭子进行PCR呼吸道病毒检测明确病因,比较不同病原体所致AECOPD的HBP与CD64的水平差异。结果 AECOPD患者HBP与CD64水平分别为(86.84±38.91)ng/mL、(6.85±2.82)MFI,明显高于COPD稳定期患者的(56.24±24.58)ng/mL、(3.32±1.09)MFI,差异均有统计学意义(P<0.01)。细菌感染与混合感染AECOPD患者HBP与CD64水平均明显高于病毒感染及非感染的AECOPD患者,差异均有统计学意义(P<0.01)。HBP与CD64对细菌感染AECOPD的敏感性均在85%以上,特异性在90%以上,明显高于混合感染及病毒感染AECOPD。结论 HBP与CD64可作为AECOPD的辅助诊断指标。

Objective To investigate the expression and significance of CD64 and neutrophils heparin binding protein（HBP）in acute exacerbation of chronic obstructive pulmonary disease（COPD）.Methods 200 inpatients and outpatients with COPD in the respiration department of our hospital from July 2013 to November 2014 were collected as the research subjects,including 100 cases of stable COPD and 100 cases of acute exacerbation COPD（AECOPD）.CD64 expression was measured by using flow cytometry and immunofluorescence,the expression of HBP was detected by enzyme-linked immunosorbent assay（ELISA）,meanwhile serum procalcitonin（PCT）,high-sensitivity C-reactive protein（hs-CRP）and white blood cell（WBC）count were detected for conducting the comparative analysis.The diagnostic value of HBP and CD64 in AECOPD was evaluated.In AECOPD patients,the sputum bacterial culture was performed and the nasal swab was conducted the PCR respiratory virus detection for determining pathogens.The HBP and CD64 expressions in AECOPD caused by different etiologies were compared.Results The expressions of HBP and CD64 in AECOPD were（86.84±38.91）ng/mL and（6.85±2.82）MFI,which were significantly higher than（56.24±24.58）ng/mL and（3.32±1.09）MFI in stable COPD,the differences were statistically significant（P〈0.01）.In different etiologies of AECOPD,the HBP and CD64 expressions in bacterial infection and mixed infection were significantly higher than those in viral infection and non-infection,the differences were statistically significant（P〈0.01）.The susceptibility and specificity of HBP and CD64 to bacterial infection were more than 85% and more than 90%,which were significantly higher than those to mixed infection and viral infection.Conclusion HBP and CD64 can be used as the assisted diagnostic markers of AECOPD.