血清可溶性清道夫受体CD163在慢性阻塞性肺疾病急性加重期中的临床意义

Clinical significance of serum soluble scavenger receptor CD163 in acute exacerbation of chronic obstructive pulmonary disease

目的评价血清可溶性清道夫受体CD163在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的表达及其临床意义,为AECOPD的诊断和治疗提供参考。方法2016年5月-2018年5月分别选择80例AECOPD患者、80例慢性阻塞性肺疾病(COPD)患者和80例健康体检者为研究对象,检测其血清sCD163含量,AECOPD患者同时进行痰液细菌培养,对AECOPD患者进行分级,数据采用SPSS21.0进行统计分析。结果80例AECOPD患者确诊为细菌感染为43例(占比53.75%),非细菌感染37例(占比46.25%)。临床分级为Ⅰ级为18例(占比22.50%),Ⅱ级为51例(占比63.75%),Ⅲ级为11例(占比13.75%)。健康体检组的sCD163含量低于COPD组和AECOPD组(P<0.001),COPD组的sCD163含量低于AECOPD组(P<0.001)。细菌培养阳性组的sCD163含量高于细菌培养阴性组(P<0.001)。临床分级为Ⅰ级组的sCD163含量低于Ⅲ级组(P=0.002),Ⅱ级组低于Ⅲ级组(P=0.016),但Ⅰ级组和Ⅱ级组之间sCD163含量的差异无统计学意义(P>0.05)。结论sCD163含量对AECOPD的早期诊断、判断细菌感染方面具有一定优势,其结果为临床医生尽快制定治疗方案具有积极作用。

Objective To evaluate the expression and clinical significance of sCD163 in serum of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to provide reference for the diagnosis and treatment of AECOPD.Methods From May 2016 to May 2018,80 patients with AECOPD,80 patients with COPD and 80 healthy people were selected as the research subjects.Serum sCD163 levels were measured.Sputum bacterial culture was carried out in AECOPD patients at the same time.AECOPD patients were graded,and the data were analyzed by SPSS 21.0.Results Among 80 AECOPD patients,43 (53.75%) were diagnosed as bacterial infection and 37 (46.25%) as non-bacterial infection.18 cases (22.50%) were classified as Grade Ⅰ,51 cases (63.75%) as Grade Ⅱ and 11 cases (13.75%) as Grade Ⅲ.The content of sCD163 in the health examination group was lower than that in the COPD group and the AECOPD group ( P< 0.001),and that in COPD group was lower than that in AECOPD group ( P< 0.001).The content of sCD163 in the positive bacterial culture group was higher than that in the negative bacterial culture group ( P< 0.001).The content of sCD163 in the grade I group was lower than that in the grade Ⅲ group ( P =0.002),and that in the grade Ⅱ group was lower than that in the grade Ⅲ group ( P =0.016),but there was no significant difference in the content of sCD163 between the grade Ⅰ group and the grade Ⅱ group ( P> 0.05).Conclusion The content of sCD163 has certain advantages in the early diagnosis of AECOPD and the judgment of bacterial infection.The results will play an active role in making treatment plans for clinicians as soon as possible.