HNL、PCT、CRP及膜联蛋白A1对COPD合并呼吸系统感染的诊断价值

发布时间：2018-04-20 01:33

本文选题：慢性阻塞性肺疾病 + 中性粒细胞载脂蛋白　；参考：《山东医药》2017年06期

【摘要】：目的探讨血清中性粒细胞载脂蛋白(HNL)、降钙素原(PCT)、C反应蛋白(CRP)及外周血单个核细胞中膜联蛋白A1表达对慢性阻塞性肺疾病(COPD)合并呼吸系统感染的诊断价值。方法选择COPD患者152例,其中合并呼吸系统病毒感染47例(病毒感染组)、细菌感染63例(细菌感染组)、无感染42例(对照组)。分别采用ELISA法、化学发光法和免疫速率法检测各组血清HNL、PCT、CRP,采用实时荧光定量PCR(qRT-PCR)和Western blot法检测各组外周血单个核细胞中膜联蛋白A1 mRNA及蛋白表达。结果细菌感染组血清HNL、PCT、CRP水平高于病毒感染组和对照组(P均0.05),病毒感染组HNL、PCT、CRP水平与对照组比较P均0.05。细菌感染组HNL、PCT、CRP阳性率分别为94.58%、85.71%、73.02%,均高于病毒感染组和对照组(P均0.05),病毒感染组血清HNL、PCT、CRP阳性率与对照组比较P均0.05。以对照组为阴性组,以细菌感染组为阳性组构建ROC曲线,HNL、PCT、CRP诊断细菌感染的灵敏度分别为91.43%、82.91%和78.22%,特异度分别为94.71%、91.35%和82.44%,阳性预测值分别为90.21%、70.81%和60.73%。细菌感染组及病毒感染组患者外周血单个核细胞中膜联蛋白A1 mRNA及蛋白表达水平较对照组均升高,病毒感染组高于细菌感染组(P均0.05)。结论联合检测血清HNL、PCT和CRP有助于COPD合并呼吸系统细菌感染和病毒感染的鉴别诊断,外周血单个核细胞中膜联蛋白A1的表达可作为其有力补充。
[Abstract]:Objective to investigate the diagnostic value of serum neutrophil apolipoprotein (HNLX), procalcitonin (PCT) C-reactive protein (CRP) and synthase A1 in peripheral blood mononuclear cells (PBMC) in patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory infection. Methods A total of 152 patients with COPD were selected, including 47 patients with respiratory system virus infection (viral infection group), 63 patients with bacterial infection (bacterial infection group) and 42 patients with no infection (control group). ELISA assay, chemiluminescence assay and immunoassay were used to detect serum HNLL-PCTV-CRP, real-time fluorescence quantitative PCRQ RT-PCR and Western blot were used to detect the expression of integrin A1 mRNA and protein in peripheral blood mononuclear cells (PBMC) of each group. Results the serum levels of HNLnLhPCTnh1 CRP in bacterial infection group were higher than those in viral infection group and control group (P 0.05), and the levels of HNLnLhPCTnh1 CRP in viral infection group were significantly higher than those in control group (P 0.05). The positive rates of HNLnLhPCTnh1 CRP in bacterial infection group were 94.58 and 85.71, respectively, which were higher than those in viral infection group and control group (P 0.05). The positive rate of serum HNLmPCTnc-CRP in viral infection group was 0.05 compared with that in control group (P < 0.05). The sensitivity of constructing ROC curve was 82.91% and 78.22%, the specificity was 94.71% and 82.44%, respectively. The positive predictive values were 90.21% and 60.73%, respectively. The expression levels of integrin A1 mRNA and protein in peripheral blood mononuclear cells of patients with bacterial infection and viral infection were higher than those of control group, and the expression levels in viral infection group were higher than those in bacterial infection group (P 0.05). Conclusion the combined detection of HNLP-PCT and CRP in serum is helpful to the differential diagnosis of COPD complicated with bacterial and viral infection of respiratory system, and the expression of integrin A1 in peripheral blood mononuclear cells can be used as an effective supplement.
【作者单位】：钦州市第一人民医院;北海市第四人民医院;
【分类号】：R56

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