【摘要】 目的观察慢性阻塞性肺疾病急性加重期(AECOPD)红细胞免疫功能及血清降钙素原(PCT)变化,并观察在抗感染治疗前后两者变化及相关性。方法采用郭峰法和化学发光法测定50例AECOPD患者和40例健康对照者外周血C3b受体花环率(RBC-C3bRR)、红细胞免疫复合物花环率(RBC-ICR)及血清降钙素原(PCT)水平及抗感染治疗前后的动态变化。结果AECOPD组治疗前RBC-C3bRR[(11.21±2.67)%]明显低于治疗后[(13.36±2.75)%]及健康对照组[(15.36±3.02)%],差异有统计学意义(P均<0.01)。AECOPD组治疗前RBC-ICR、PCT[(9.05±2.39)%,(0.29±0.15)ng/ml]明显高于治疗后[(7.95±1.55)%,(0.09±0.03)ng/ml]及健康对照组[(5.89±1.82)%,(0.08±0.05)ng/ml],差异有统计学意义(P均<0.01)。AECOPD患者组PCT水平与RBC-C3bRR呈显著负相关(r=-0.421,P<0.01),与RBC-ICR呈显著正相关(r=0.488,P<0.01)。结论 PCT是早期诊断AECOPD的敏感和有价值的指标,且AECOPD患者存在红细胞免疫功能的下降,可能是临床症状反复发作的原因。更多还原

【Abstract】 Objective To observe the changes of erythrocyte innate immune function and procalcitonin( PCT) levels in elderly patients with AECOPD. Methods The rosette rate of red-cell C3 b receptors( RBCC3bRR),red-cell immune complex( RBC-ICR) and serum PCT in the fresh peripheral blood were detected in 50 patients with AECOPD and 40 healthy controls by Guo-Feng method and chemoluminescence respectively. Results The rosette rate of RBC-C3 bRR was( 11. 21 ± 2. 67) % in AECOPD patients before the treatment,which was significantly lower than that of AECOPD patients after the treatment( 13. 36 ± 2. 75%) and the healthy controls( 15. 36 ±3. 02%)( P < 0. 01). The levels of RBC-ICR and PCT were( 9. 05 ± 2. 39) % and( 0. 29 ± 0. 15) ng / ml in AECOPD patients before the treatment,which were obviously higher that those of patients with AECOPD after the treatment( 7. 95 ± 1. 55%) and( 0. 09 ± 0. 03) ng/ml and( 5. 89 ± 1. 82) % and( 0. 08 ± 0. 05) ng/ml in the control group( P< 0. 01). Correlation analysis of PCT and RBC-C3 bRR in AECOPD patients revealed a significant negative correlation( r =- 0. 421,P < 0. 01),and PCT and RBC-ICR showed a significant positive correlation( r = 0. 488,P <0. 01). Conclusion Serum PCT is a valuable and sensitive indicator for early diagnosis of AECOPD. AECOPD patients has obvious suppression of erythrocyte innate immune function,which may cause the recurrence of AECOPD.更多还原