中性粒细胞补体受体1和补体受体3在COPD细菌感染中的诊断价值

目的探讨中性粒细胞补体受体1（CR1）和补体受体3（CR3）在慢性阻塞性肺疾病急性加重期（AECOPD）诊断细菌感染的作用。方法选取2008年12月至2009年7月在昆明医学院第二附属医院呼吸内科住院治疗的AECOPD患者40例,根据细菌检出结果分为细菌检出组25例,未检出细菌组15例。同时纳入COPD缓解期患者20例,同期无吸烟史体检指标正常者20例作为正常对照组。根据Anthonisen标准对AECOPD患者分组,40例分为Ⅰ型11例、Ⅱ型12例和Ⅲ型17例。流式细胞仪检测血的CR1和CR3水平。运用ROC曲线分析,判断CR1、CR3区分AECOPD细菌感染的敏感性和特异性。结果①AECOPD细菌检出组中CR1、CR3明显高于AECOPD未检出组、COPD缓解期组和正常对照组。②Anthonisen标准分组发现Ⅰ型CR1、CR3明显高于Ⅱ型、Ⅲ型。③CR1的ROC曲线分析最佳临界点为11,此时的敏感性为0.875,特异性为0.925。CR3曲线下最佳临界点为52,此时的敏感性为0.925,特异性为0.925。结论 CR1、CR3在区分细菌感染引起AECOPD具有较好的判别价值。

The Role of the Complement Receptor 1 and 3 on Neutrophils in Distinguishing Bacterial Infection in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective To study the role of the complement receptor 1 and 3（CR1 and CR3） on neutrophils in distinguishing bacterial infection in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods 40 patients with AECOPD were divided into two groups according to the detection of bacteria in subairway.20 patients with stable COPD and 20 healthy subjects with no history of smoking were also included.According to Anthonisen criteria,40 AECOPD patients were divided into type Ⅰ（11 cases）,type Ⅱ（12 cases）,and type Ⅲ（17 cases）.The levels of CR1 and CR3 in blood were measured by flow cytometry.Results In AECOPD patients,25 cases were detected bacteria,and 15 cases were not detected bacteria.The level of CR1 and CR3 were highest in the bacterial infection group than other groups,and highest in type Ⅰ AECOPD patients than other types.ROC analysis showed that CR1 and CR3 had good diagnostic value in bacterial infection in AECOPD,with optimal cutoff values of 11 and 52,respectively.Conclusion CR1 and CR3 may be good index of distinguishing bacterial infection in AECOPD.