慢性阻塞性肺疾病合并肺部真菌感染患者血浆(1-3)-β-D葡聚糖与sTREM-1的表达

Expression of plasma (1-3)-β-D glucan and soluble triggering receptor expressed on myeloid cells in chronic obstructive pulmonary disease patients complicated with pulmonary fungal infection

目的探讨慢性阻塞性肺疾病(COPD)合并真菌感染患者血浆(1-3)-β-D葡聚糖与可溶性髓样细胞触发受体-1(sTREM-1)的表达,为患者临床诊治提供参考。方法选取2017年6月-2018年6月在宁波市第四医院住院初步诊断为COPD合并肺部真菌感染的100例患者,收集痰液进行感染病原菌检测,抽取患者外周静脉血检测血浆(1-3)-β-D葡聚糖与sTREM-1。结果74例患者确诊为肺部真菌感染,占74.00%,26例为细菌感染,占26.00%,肺部真菌感染的患者其中52例同时合并细菌感染、22例为单纯真菌感染,分别占52.00%、22.00%;真菌感染患者其中34例白假丝酵母感染、20例热带假丝酵母感染,分别占45.95%、27.03%;真菌感染患者血浆(1-3)-β-D葡聚糖与sTREM-1分别为(43.33±28.40)pg/ml、(18.09±5.17)ng/L,高于无真菌感染患者(P<0.05);相关性分析结果显示真菌感染患者血浆(1-3)-β-D葡聚糖与sTREM-1之间有正相关性(P<0.05)。结论COPD合并肺部真菌感染患者感染病原菌主要为白假丝酵母和热带假丝酵母,真菌感染患者血浆(1-3)-β-D葡聚糖与sTREM-1均明显升高,用于肺部真菌感染的临床诊治具有指导价值。

OBJECTIVE To explore the expression of plasma(1-3)-β-D glucan and soluble triggering receptor expressed on myeloid cells(sTREM-1)in chronic obstructive pulmonary disease(COPD)patients complicated with pulmonary fungal infection so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 100 patients who were preliminarily diagnosed with COPD complicated with pulmonary fungal infection and were hospitalized in the Fourth Hospital of Ningbo from Jun 2017 to Jun 2018 were enrolled in the study.The sputum specimens were collected from the patients for detection of pathogens,and the peripheral blood samples were drawn for detection of plasma(1-3)-β-D glucan and sTREM-1.RESULTS Totally 74 patients were confirmed with pulmonary fungal infection,accounting for 74.00%;26 patients were conformed with bacterial infection,accounting for 26.00%.Among the patients with pulmonary fungal infection,52(52.00%)were complicated with bacterial infection,and 22(22.00%)were complicated with simple fungal infection.Among the patients with fungal infection,34(45.95%)had Candida albicans infection,and 20(27.03%)had C.tropicalis infection.The levels of plasma(1-3)-β-D glucan and sTREM-1 of the patients with fungal infection were respectively(43.33±28.40)pg/ml and(18.09±5.17)ng/L,significantly higher than those of the patients without fungal infection(P<0.05).The correlation analysis showed that the plasma(1-3)-β-D glucan of the patients with fungal infection was positively correlated with the sTREM-1(P<0.05).CONCLUSION C.albicans and C.tropicalis are dominant among the pathogens causing the pulmonary fungal infection in the COPD patents.The levels of plasma(1-3)-β-D glucan and sTREM-1 of the patients with fungal infection are remarkably elevated,which are valuable for guidance of clinical diagnosis and treatment of the pulmonary fungal infection.