慢性阻塞性肺疾病急性加重期HBP和CD64表达与不同细菌感染的关系

发布时间：2018-08-17 17:29

【摘要】：目的通过观察慢性阻塞性肺疾病急性加重期(AECOPD)患者不同细菌感染时肝素结合蛋白(HBP)和CD64血浆水平,探讨HBP和CD64表达与细菌感染的关系;测定细菌感染时肌钙蛋白(cTnI)的血清水平,分析HBP与心肌损伤的相关性。方法根据标本中下呼吸道细菌浓度107cfu/mL作为细菌感染的诊断标准,将AECOPD患者分为细菌感染组[100例,分革兰阳性菌感染组(41例)和革兰阴性菌感染组(59例)]、非细菌感染组(80例)及健康志愿者(健康对照组80例)。各组分别用流式细胞术检测外周血白细胞CD64的平均荧光强度(MFI),并换算成CD64指数,酶联免疫吸附试验测定血浆HBP水平,自动免疫荧光法测定cTnI水平。评价HBP与CD64对AECOPD细菌感染的诊断价值,并分析HBP与cTnI的相关性。结果细菌感染组HBP和CD64水平明显高于非细菌感染组[HBP:(86.8±27.39)ng/mL vs(29.35±7.54)ng/mL;CD64指数:6.28±2.23 vs 0.69±0.19]和健康对照组[HBP:(16.08±4.45)ng/mL,CD64指数:0.47±0.12](F=960.97,P0.01;F=108.43,P0.01)。非细菌感染组与健康对照组HBP水平差异无统计学意义(P0.05),但CD64水平差异有统计学意义(P0.05)。革兰阳性菌感染组HBP水平显著高于革兰阴性菌感染组[HBP:(95.88±11.61)ng/mL vs(74.32±17.84)ng/mL](t=6.795,P0.01)。细菌感染组HBP的血浆水平与cTnI呈正相关(r=0.904)。结论 HBP与CD64可以作为AECOPD患者细菌感染的诊断指标。依据HBP血浆水平能初步判断AECOPD患者细菌感染的种类以及感染对心脏功能的影响,对指导临床用药意义重大。
[Abstract]:Objective to investigate the relationship between the expression of HBP and CD64 and bacterial infection by observing the plasma levels of heparin binding protein (HBP) and CD64 in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to determine the serum level of troponin (cTnI) during bacterial infection. To analyze the correlation between HBP and myocardial injury. Methods according to the 107cfu/mL concentration in the lower respiratory tract, the patients with AECOPD were divided into bacterial infection group (n = 100) and bacterial infection group (n = 100). Gram-positive bacteria infection group (41 cases), Gram-negative bacteria group (59 cases), non-bacterial infection group (80 cases) and healthy volunteers (healthy control group 80 cases) were divided into three groups: Gram-positive bacterial infection group (41 cases) and Gram-negative bacterial infection group (59 cases). The mean fluorescence intensity (MFI),) of CD64 in peripheral blood leukocytes was measured by flow cytometry and converted into CD64 index. The plasma HBP level was measured by enzyme-linked immunosorbent assay (Elisa) and the cTnI level was measured by automatic immunofluorescence assay. To evaluate the value of HBP and CD64 in the diagnosis of AECOPD bacterial infection and to analyze the correlation between HBP and cTnI. Results the levels of HBP and CD64 in the bacterial infection group were significantly higher than those in the non-bacterial infection group [(86.8 卤27.39) ng/mL vs (29.35 卤7.54) ng / ml CD64 index vs 0.69 卤0.19] and the healthy control group [(16.08 卤4.45) ng / mL CD64 index: 0.47 卤0.12] (FF960.97P0.01P0.01F108.43P0.01). There was no significant difference in HBP level between non-bacterial infection group and healthy control group (P0.05), but there was significant difference in CD64 level (P0.05). The level of HBP in Gram-positive bacterial infection group was significantly higher than that in Gram-negative bacterial infection group [(95.88 卤11.61) ng/mL vs (74.32 卤17.84) ng/mL]. The plasma level of HBP was positively correlated with cTnI in bacterial infection group (r = 0.904). Conclusion HBP and CD64 can be used as diagnostic indexes of bacterial infection in AECOPD patients. According to the plasma level of HBP, the type of bacterial infection in patients with AECOPD and the influence of infection on heart function can be preliminarily judged, which is of great significance for guiding clinical drug use.
【作者单位】：广州医科大学附属第五医院呼吸内科;广州医科大学附属第五医院检验科;
【基金】：广东省医学科学技术研究基金项目(编号:A2015359)
【分类号】：R563.9

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