MPO检测在COPD合并铜绿假单胞菌感染中的临床意义

Clinical significance of MPO detecting in COPD patients with Pseudomonas aeruginosa infection

目的探究慢性阻塞性肺疾病(COPD)患者合并铜绿假单胞菌(PA)感染时血清MPO水平的改变及临床意义。方法选取2018年10月1日至2019年9月30日在该院确诊的COPD患者126例作为研究对象,其中47例患者痰培养鉴定出PA,纳入PA(+)组,其余79例患者痰培养未检出PA,纳入PA(-)组。另选取同期体检健康者40例作为健康对照组。采用酶联免疫吸附试验(ELISA法)测定血清MPO水平,采用Spearman分析MPO与白细胞介素6(IL-6)、C反应蛋白(CRP)和血常规参数之间的相关性,以及MPO与肺功能指数之间的关系。结果PA(+)组血清MPO水平[(253.39±88.93)ng/mL]显著高于PA(-)组[(152.87±60.97)ng/mL]和健康对照组[(61.25±22.10)ng/mL],差异均有统计学意义(P<0.01)。MPO与炎症指标中性粒细胞计数(NEU)、淋巴细胞计数(LYM)、中性粒细胞与淋巴细胞计数比值(NLR)、IL-6均有一定相关性,其中MPO和IL-6的相关性最大(r=0.593,P<0.001)。血清MPO水平与肺功能指数第1秒用力呼气容积占用力肺活量比值(FEV 1/FVC)、第1秒用力呼气容积占预计值百分比(FEV 1%pred)呈负相关(r=-0.579,P<0.001;r=-0.528,P<0.001)。MPO水平在不同GOLD分级COPD患者中差异有统计学意义(P<0.05)。结论COPD患者合并PA感染时血清MPO水平升高,MPO可用于反映患者体内炎性反应状态,是患者病情监测的潜在生物标志物。

Objective To investigate the changes in serum MPO levels and the clinical significance of MPO detection in COPD patients with PA infection.Methods Totally 126 patients diagnosed with COPD in the hospital from October 1,2018 to September 30,2019 were enrolled in the study.Among them,47 patients were identified with PA in sputum culture and included in the PA(+)group,while the remaining 79 patients were not detected with PA in sputum culture and included in the PA(-)group.Another 40 healthy subjects were selected as the healthy control group.Serum MPO levels were measured by enzyme linked immunosorbent assay(ELISA).Spearman correlation was used to analyze the correlation between MPO and interleukin 6(IL-6),C-reactive protein(CRP)and blood routine parameters,as well as the relationship between MPO and pulmonary function index.Results The serum MPO level of the PA(+)group[(253.39±88.93)ng/mL]was significantly higher than that of the PA(-)group[(152.87±60.97)ng/mL]and healthy control group[(61.25±22.10)ng/mL],and the difference was statistically significant(P<0.01).There was a certain correlation between MPO and inflammatory indicators such as NEU,LYM,NLR and IL-6,and the correlation between MPO and IL-6 was the most significant(r=0.593,P<0.001).Serum MPO level was negatively correlated with pulmonary function index FEV 1/FVC(r=-0.579,P<0.001)and FEV 1%pred(r=-0.528,P<0.001).There was statistically significant difference in MPO level among COPD patients with different GOLD grades(P<0.05).Conclusion Serum MPO level is increased in COPD patients complicated with PA infection.MPO can be used to reflect the inflammatory response status in patients and is a potential biomarker for disease monitoring in patients.