CD64和 PCT在慢性阻塞性肺疾病急性加重风险评估中的价值

目的：探讨中性粒细胞CD64平均荧光强度指数（ CD64指数）、降钙素原（ PCT）在慢性阻塞性肺疾病急性加重（ AECO-PD）风险评估中的价值。方法入选AECOPD 56例，均有痰量增多伴有脓性痰，根据2011年COPD全球策略评估COPD急性加重风险，并根据风险高低分为高风险组（ A组， n＝24）和低风险组（ B组， n＝32）。治疗前后均检测CD64、PCT、CRP及WBC。结果 A组患者CD64、PCT水平高于B组（P＜0．01）；CD64、PCT与CRP呈正相关（P＜0．05），与WBC无相关性（P＞0．05）；数据分析显示以CD64＞3．505、PCT ＞0．053μg＆#183; L-1为阳性阈值，CD64和PCT判定COPD急性加重高风险的敏感度分别为90．0％、93．3％，特异度分别为96．7％、96．7％。结论 COPD急性加重期CD64和PCT水平可作为判定未来急性加重风险高低的有效指标。

Significance of CD64 and PCT in risk assessment of the acute exacerbation of chronic obstructive pulmonary disease

Objective To investigate the risk assessment significance of the neutrophil CD 64 mean fluorescence intensity index and pro-calcitonin（PCT） in the acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.Methods A total of 56 AECOPD pa-tients,who had sputum volume increased with purulent sputum and had the risk of acute exacerbation of COPD evaluated according to the 2011 COPD global strategy,were assigned into high risk group （group A,n=24） and low risk group（group B,n=32）.Before and after treatment CD64,PCT,CRP and WBC were detected .Results The levels of CD64 and PCT in group A were higher than those in group B（P＆lt;0.01）.Evidence showed that the levels of CD64 and PCT in AECOPD cases were correlated with level of CRP （P＆lt;0.05）,but not with WBC（P＆gt;0.05）.Data analysis showed CD64＆gt;3.505,PCT ＆gt;0.053 μg＆#183; L-1 as positive threshold.Sensitivities of CD64 and PCT in determining the high risk of acute exacerbations of COPD were 90%,93.3% respectively,and specificities were 96.7%,96.7%respectively.Conclusions The expression of CD64 and PCT in AECOPD patients may be effective index of judging the risk of acute exacerbations in future .