鉴别诊断临床急性肺炎病原体感染的血清标志物研究

doi:10.3969/j.issn.1006-7795.2016.05.016

首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (5): 636-640.doi: 10.3969/j.issn.1006-7795.2016.05.016

鉴别诊断临床急性肺炎病原体感染的血清标志物研究

刘萌^1,2, 窦云鹏³, 谷丽¹, 吕喆³, 王一民⁴, 刘颖梅⁴, 安云庆³, 曹彬^2,4

1. 首都医科大学附属北京朝阳医院感染与临床微生物科北京呼吸疾病研究所, 北京 100020;
2. 首都医科大学呼吸病学系, 北京 100069;
3. 首都医科大学免疫学系首都医科大学微生态研究中心, 北京 100069;
4. 中日友好医院呼吸与危重症医学科二部, 北京 100029

收稿日期:2016-09-05 出版日期:2016-10-21 发布日期:2016-10-19
通讯作者: 安云庆, 曹彬 E-mail:anyunq@ccmu.edu.cn;caokin_ben@163.com
基金资助:
国家自然科学基金项目（81271840），国家青年杰出基金项目（81425001）。

Studies of serum biomarkers to differentiate and diagnose acute pneumonia pathogens infection

Liu Meng^1,2, Dou Yunpeng³, Gu Li¹, Lyu Zhe³, Wang Yimin⁴, Liu Yingmei⁴, An Yunqing³, Cao Bin^2,4

1. Department of Infectious Diseases and Clinical Microbiology, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine, Beijing 100020, China;
2. Department of Immunology, Capital Medical University, Beijing 100069, China;
3. Department of Immunology, Microecology Research Center, Capital Medical University, Beijing 100069, China;
4. Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China

Received:2016-09-05 Online:2016-10-21 Published:2016-10-19
Supported by:
This study was supported by National Natural Science Foundation of China(81271840), National Science for Distinguished Young Scholars(81425001).

摘要/Abstract

摘要： 目的检测急性肺炎患者血清相关生物标志物含量，为建立一种快速鉴别诊断临床急性支原体肺炎、病毒性肺炎、细菌性肺炎的免疫胶体金检测法提供实验依据。方法以临床病原学诊断明确的急性支原体肺炎，病毒性肺炎，细菌性肺炎患者和正常人血清为检测样品，采用血小板衍生生长因子（platelet-derived growth factor，PDGF）/杀菌渗透增强蛋白（bactericidal/permeability-increasing protein，BPI）酶联免疫法（enzyme-linked immunosorbent assay，ELISA）检测试剂盒检测上述血清中相关生物标志物含量。结果（1）正常人群血清78份，急性支原体肺炎患者血清46份，病毒性肺炎和细菌性肺炎患者血清42份，其中病毒感者患者血清35份，细菌感染患者血清7份；（2）正常人群血清PDGF最大值<6 000 pg/mL；血清BPI最大值<80 ng/mL；（3）以血清PDGF值6 000 pg/mL作为鉴别诊断急性支原体感染的基线值，支原体感染患者阳性检出率为93.47%（43/46）；病毒和细菌感染患者出现支原体感染的假阳性率为7.14%（3/42）；（4）以血清BPI值80 ng/mL作为鉴别诊断急性细菌感染的基线值，细菌感染患者阳性检出率为85.71%（6/7）；病毒感染患者出现细菌感染的假阳性率为3.22%（1/31）。结论以血清PDGF 6 000 pg/mL和BPI 80 ng/mL作为鉴别诊断不同病原体感染的基线值，对临床急性支原体肺炎、病毒性肺炎、细菌性肺炎鉴别诊断具有一定意义。

关键词: 肺炎, 鉴别诊断, 血小板衍生生长因子, 杀菌渗透增强蛋白

Abstract: Objective To provide the experimental basis of a rapid immune colloidal gold test which used to differentiate and diagnose acute pneumonia patients infected with mycoplasma pneumoniae(MP)/virus/bacteria. Methods The level of platelet-derived growth factor (PDGF) and bactericidal/permeability-increasing protein (BPI) in the serum of acute pneumonia patients with definite infection of mycoplasma pneumoniae/virus/bacteria and healthy controls were measured by enzyme-linked immunosorbent assay (ELISA) method. Results There were 78 serum samples from healthy controls, 46 from acute MP patients, 42 from acute bacterial and viral pneumonia patients (7 from bacterial pneumonia and 35 from viral pneumonia patients). (2) PDGF values of healthy controls were all less than 6 000 pg/mL; BPI values were all less than 80 ng/mL. (3) If definition of the baseline value of PDGF which could diagnose acute MP infection is as 6 000 pg/mL, the positive detection rate of MP pneumonia patients was 93.47% (43/46), and the MP false positive rate of patients with viral or bacterial pneumonia was 7.14% (3/42). (4) If definition of the baseline value of BPI which could diagnose acute bacterial infection is 80ng/mL, the positive detection rate of patients with bacterial pneumonia was 85.71% (6/7), and the bacteria false positive rate of viral pneumonia patients was 3.22% (1/31). Conclusion Using PDGF's baseline value as 6 000 pg/mL and BPI's 80 ng/mL to differential diagnosis has some clinical significance to differentiate acute MP/virus/bacterium infection.

Key words: pneumonia, differentiation diagnosis, platelet-derived growth factor, bactericidal/permeability-increasing protein

中图分类号:

R563.1

刘萌, 窦云鹏, 谷丽, 吕喆, 王一民, 刘颖梅, 安云庆, 曹彬. 鉴别诊断临床急性肺炎病原体感染的血清标志物研究[J]. 首都医科大学学报, 2016, 37(5): 636-640.

Liu Meng, Dou Yunpeng, Gu Li, Lyu Zhe, Wang Yimin, Liu Yingmei, An Yunqing, Cao Bin. Studies of serum biomarkers to differentiate and diagnose acute pneumonia pathogens infection[J]. Journal of Capital Medical University, 2016, 37(5): 636-640.

参考文献

[1] Qu J X, Gu L, Pu ZH, et al. Viral etiology of community-acquired pneumonia among adolescents and adults with mild or moderate severity and its relation to age and severity[J]. BMC Infect Dis, 2015,15:89.
[2] 李福长, 刘梨平. 我国抗生素滥用现状及其对策[J]. 临床合理用药杂志, 2014, 7(9):175-177.
[3] Heiskanen-Kosma T, Korppi M. Serum C-reactive protein cannot differentiate bacterial and viral aetiology of community acquired pneumonia in children in primary healthcare settings[J]. Scand J Infect Dis, 2000,32(4):399-402.
[4] Horie M, Ugajin M, Suzuki M, et al. Diagnostic and prognostic value of procalcitonin in community-acquired pneumonia[J]. Am J Med Sci, 2012,343(1):30-35.
[5] 曾德颖, 陈燕情, 汤利芹, 等. 降钙素原在儿童下呼吸道感染的应用研究[J]. 中国医药科学, 2016, 6(12):43-45.
[6] Heldin C H, Westermark B. Mechanism of action and in vivo role of platelet-derived growth factor[J]. Physiol Rev, 1999,79(4):1283-1216.
[7] Andrae J, Gallini R, Betsholtz C. Role of platelet-derived growth factors in physiology and medicine[J]. Genes Dev, 2008,22(10):1276-1312.
[8] Heldin C H, Westermark B. Mechanism of action and in vivo role of platelet-derived growth factor[J]. Physiol Rev, 1999,79(4):1283-1316.
[9] 刘健, 彭东信, 刘晓晴, 等. 肺炎支原体反复感染大鼠肺组织中PDGF-BB变化的免疫组织化学研究[J]. 中国组织化学与细胞化学杂, 2001,10(1):76-79.
[10] Liu J, Peng D, Zhu Z, et al. The expression of PDGF-BB chain mRNA in lung tissue from rats repeatedly infected with mycoplasma pneumonia[J]. J Tongji Med Univ, 1998,18(4):216-220.
[11] Balakrishnan A, Marathe S A, Joglekar M, et al. Bactericidal/permeability increasing protein:A multifaceted protein with functions beyond LPS neutralization[J]. Innate Immun, 2012,19(4):339-347.
[12] Domingues M M, Silva P M, Franquelim H G, et al. Antimicrobial protein rBPI21-induced surface changes on Gram-negative and Gram-positive bacteria[J]. Nanomedicine, 2014,10(3):543-551.
[13] Aichele D, Schnare M, Saake M, et al. Expression and antimicrobial function of bactericidal permeability-increasing protein in cystic fibrosis patients[J]. Infect Immun, 2006,74(8):4708-4714.
[14] 蒋旭, 李青竹, 邱月红, 等. 胶体金免疫层析技术研究进展[J]. 兽医研究, 2015,5:28-29.
[15] 薛天羽, 赵杨,林锦锋,等. 免疫学方法确证人血痕的研究及应用现状[J]. 中国煤炭工业医学杂志,2014,17(12):2101-2105.

鉴别诊断临床急性肺炎病原体感染的血清标志物研究

Studies of serum biomarkers to differentiate and diagnose acute pneumonia pathogens infection

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