中性粒細胞補體受體1 和補體受體3 在COPD 細菌感染中的診斷價值_《中國呼吸與危重監護雜志》

作者：

董昭興 , 余國輝 , 柴燕玲 , 李其皓 , 張濤

昆明醫學院第二附屬醫院呼吸內科( 云南昆明 650101) 通訊作者: 張濤, E-mail: zt6958@ sina. com;

關鍵詞：

慢性阻塞性肺疾病細胞感染中性粒細胞補體受體1 中性粒細胞補體受體3

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目的探討中性粒細胞補體受體1( CR1) 和補體受體3( CR3) 在慢性阻塞性肺疾病急性加重期( AECOPD) 診斷細菌感染的作用。方法選取2008 年12 月至2009 年7 月在昆明醫學院第二附屬醫院呼吸內科住院治療的AECOPD 患者40 例, 根據細菌檢出結果分為細菌檢出組25 例, 未檢出細菌組15 例。同時納入COPD 緩解期患者20 例, 同期無吸煙史體檢指標正常者20 例作為正常對照組。根據Anthonisen 標準對AECOPD 患者分組, 40 例分為Ⅰ型11 例、Ⅱ型12 例和Ⅲ型17 例。流式細胞儀檢測血的CR1 和CR3 水平。運用ROC 曲線分析, 判斷CR1、CR3 區分AECOPD 細菌感染的敏感性和特異性。結果 ①AECOPD 細菌檢出組中CR1、CR3 明顯高于AECOPD 未檢出組、COPD 緩解期組和正常對照組。②Anthonisen 標準分組發現Ⅰ 型CR1、CR3 明顯高于Ⅱ 型、Ⅲ 型。③CR1 的ROC 曲線分析最佳臨界點為11, 此時的敏感性為0. 875, 特異性為0. 925。CR3 曲線下最佳臨界點為52, 此時的敏感性為0. 925, 特異性為0. 925。結論 CR1、CR3 在區分細菌感染引起AECOPD 具有較好的判別價值。

引用本文： 董昭興,余國輝,柴燕玲,李其皓,張濤. 中性粒細胞補體受體1 和補體受體3 在COPD 細菌感染中的診斷價值. 中國呼吸與危重監護雜志, 2010, 9(5): 481-484. doi: 復制

1.	Lindenauer PK, Pekow P, Gao S, et al. Quality of care for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease. Ann Intern Med, 2006, 144 : 894-903.
2.	中華醫學會呼吸病學分會慢性阻塞性肺疾病學組. 慢性阻塞性肺疾病診治指南( 2007 年修訂版) . 中華結核和呼吸雜志,2007, 30: 8-17.
3.	Pavord ID, Pizzichini MM, Pizzichini E, et al. The use of induced sputumto investigate airway inflammation. Thorax.1997, 52: 498-501.
4.	Anthonisen NR, Manfreda J,Warren CP, et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med, 1987, 106: 196 -204.
5.	Simon L, Gauvin F, Amre DK, et al. Serum procalcitonin and Creactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis, 2004, 39: 206 -217.
6.	Polzin A, Pletz M, Erbes R, et al. Procalcitonin as a diagnostic tool in lower respiratory tract infections and tuberculosis. Eur Respir J,2003, 21: 939-943 .
7.	Elghetany MT. Surface antigen changes during normal neutrophilic development: a critical review. Blood Cells Mol Dis, 2002, 28: 260 -274.
8.	Krych M, Hauhart R, Atkinson JP. Structure-function analysis of the active sites of complement receptor type 1 . J Biol Chem, 1998, 273 :8623-8629.
9.	Etzioni A. Adhesion molecules———their role in health and disease.Pediatr Res, 1996 , 39: 191 -198.
10.	Cohen JH, Atkinson JP, Klickstein LB, et al. The C3b /C4 b receptor ( CR1, CD35 ) on erythrocytes: methods for study of the polymorphisms. Mol Immunol, 1999, 36: 819-825 .
11.	Nuutila J, Hohenthal U, Laitinen I, et al. Quantitative analysis of complement receptors, CR1 ( CD35 ) and CR3 ( CD11b ) , on neutrophils improves distinction between bacterial and viral infections in febrile patients: comparison with standard clinical laboratory data. J Immunol Methods, 2006, 315: 191 -201.
12.	Soler N, Agusti C, Angrill J, et al. Validation of Anthonisen criteria in infectious COPD exacerbation among patients requiring hospitalization. Eur Respir J, 2004, 24: 411s.

1. Lindenauer PK, Pekow P, Gao S, et al. Quality of care for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease. Ann Intern Med, 2006, 144 : 894-903.
2. 中華醫學會呼吸病學分會慢性阻塞性肺疾病學組. 慢性阻塞性肺疾病診治指南( 2007 年修訂版) . 中華結核和呼吸雜志,2007, 30: 8-17.
3. Pavord ID, Pizzichini MM, Pizzichini E, et al. The use of induced sputumto investigate airway inflammation. Thorax.1997, 52: 498-501.
4. Anthonisen NR, Manfreda J,Warren CP, et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med, 1987, 106: 196 -204.
5. Simon L, Gauvin F, Amre DK, et al. Serum procalcitonin and Creactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clin Infect Dis, 2004, 39: 206 -217.
6. Polzin A, Pletz M, Erbes R, et al. Procalcitonin as a diagnostic tool in lower respiratory tract infections and tuberculosis. Eur Respir J,2003, 21: 939-943 .
7. Elghetany MT. Surface antigen changes during normal neutrophilic development: a critical review. Blood Cells Mol Dis, 2002, 28: 260 -274.
8. Krych M, Hauhart R, Atkinson JP. Structure-function analysis of the active sites of complement receptor type 1 . J Biol Chem, 1998, 273 :8623-8629.
9. Etzioni A. Adhesion molecules———their role in health and disease.Pediatr Res, 1996 , 39: 191 -198.
10. Cohen JH, Atkinson JP, Klickstein LB, et al. The C3b /C4 b receptor ( CR1, CD35 ) on erythrocytes: methods for study of the polymorphisms. Mol Immunol, 1999, 36: 819-825 .
11. Nuutila J, Hohenthal U, Laitinen I, et al. Quantitative analysis of complement receptors, CR1 ( CD35 ) and CR3 ( CD11b ) , on neutrophils improves distinction between bacterial and viral infections in febrile patients: comparison with standard clinical laboratory data. J Immunol Methods, 2006, 315: 191 -201.
12. Soler N, Agusti C, Angrill J, et al. Validation of Anthonisen criteria in infectious COPD exacerbation among patients requiring hospitalization. Eur Respir J, 2004, 24: 411s.

《中國呼吸與危重監護雜志》

中性粒細胞補體受體1 和補體受體3 在COPD 細菌感染中的診斷價值

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《中國呼吸與危重監護雜志》

中性粒細胞補體受體1 和補體受體3 在COPD 細菌感染中的診斷價值

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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