1.Expression and clinical significance of HBP and CD64 in the acute exacerbation of chronic obstructive pulmonary disease
Duanming HE ; Yanqiong JIANG ; Chunyun ZHANG ; Huiyan WU
The Journal of Practical Medicine 2016;32(18):3014-3018
Objective To investigate the expression and clinicalsignificance of neutrophils heparin binding protein (HBP) and CD64 in the chronic obstructive pulmonary disease to explore the clinical value. Methods From March 2015 to December 2015 , 197 patients with chronic obstructive pulmonary disease (COPD), 223 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and 265 healthy persons were recruited in this study. 223 patients with AECOPD were divided into two groups based on bacteria concentration in lower respiratory. Infection group was defined as patients with bacteria concentration exceeded 107 cfu/mL group. The rest of patients were in the non-bacterial infection group. Flow cytometry was used to analyzeexpression of CD64 and convert to index of CD64. Enzyme-linked immunosorbent assay (ELISA) was used to analyze expression of HBP. PCT, hs-CRP and WBC were measured at the same time. Results CD64 , HBP , CRP , WBC and PCT were highly expressed inthe acute exacerbation of chronic obstructive pulmonary patients than those in the chronic obstructive pulmonary patients and healthy group (P<0.01). CD64, HBP , CRP , WBC and PCT were highly expressed inthe acute exacerbation of chronic obstructive pulmonary bacterial infection group patients before treatment than thenon-bacterial infection group (P<0.01). HBP, CD64, CRP , WBC and PCT decline dramatically inthe AECOPDbacterial infection group patients after treatment , which were close to the levels in non-bacterial infection group.When the intercept value of CD64 index was defined as 4.0, the sensitivity to diagnose AECOPD bacterial infection was 92.2% with specificity of 86.2%. When the intercept value of HBP index was defined as 49 ng/mL , the sensitivity to diagnose AECOPD bacterial infection was 87.3% with specificity of 92.3%. Therefore, 4.0 of CD64 index and 49ng/ml of HBP index could be used as sensitive indicator of AECOPD detectedby bacterial infections. Conclusion HBP,CD64 were highly expressed in the acute exacerbation of chronic obstructive pulmonary patients than the those of chronic obstructive pulmonary patients and healthygroup, and decline dramatically after treatment. HBP and CD64 has high sensitivity and specificity to diagnose AECOPD bacterial infection. HBP and CD64 could be used as the indicators of auxiliary diagnosis of acute exacerbation of chronic obstructive pulmonary disease and to guide the clinical medication.