目的 探讨血清巨噬细胞迁移抑制因子(MIF)用于诊断慢性阻塞性肺病急性加重(AECOPD)的临床价值.方法 纳入2013年3月至2016年3月住院的AECOPD患者66例(AECOPD组),同时纳入稳定状态COPD患者38例(sCOPD组)及健康对照人员30例(健康对照组).患者就诊时收集一般情况,并常规检测实验室指标.使用酶联免疫方法检测患者血清MIF、降钙素原及C反应蛋白水平.ROC曲线分析MIF、PCT及C反应蛋白用于区分AECOPD及sCOPD的诊断价值.结果 AECOPD组血清MIF水平[(48.40±26.58)ng/ml]显著高于sCOPD组[(28.37±19.40)ng/ml]及健康对照组[(8.33±7.95)ng/ml],差异有统计学意义(P<0.001).AECOPD组中,血清MIF水平与CRP(R=0.409,P=0.001)、PCT(R=0.614,P<0.001)、WBC(R=0.554,P<0.001)及GOLD分级(Rs=0.344,P=0.005)呈显著正相关,与FEV1%(R=-0.395,P=0.001)、PO2(R=-0.400,P=0.001)呈显著负相关.单独使用血清MIF水平区别诊断AECOPD与sCOPD的AUC为0.726,MIF联合PCT及CRP的AUC为0.774.结论 血清MIF水平在AECOPD患者中显著升高,且可作为区别诊断AECOPD及sCOPD的指标.%Objective To investigate the clinical value of serum macrophage migration inhibitory factor(MIF)level in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 66 patients with AECOPD from March 2013 to March 2016 were enrolled,38 patients with stable COPD(sCOPD group)and 30 healthy people(control group)were also enrolled. General situations and laboratory parameters were recorded. The MIF,C-reactive protein(CRP)and procalcitonin(PCT)levels were detected with enzyme-linked immunosorbent assay. Results The MIF level in AECOPD group[(48.40±26.58)ng/ml]was significantly higher than sCOPD group [(28.37±19.40)ng/ml]and control group[(8.33±7.95)ng/ml]. In AECOPD group,MIF was significantly positively associated with CRP (R=0.409,P=0.001),PCT(R=0.614,P<0.001),WBC(R=0.554,P<0.001)and GOLD grade(Rs=0.344,P=0.005),and MIF was negatively associated with PO2(R=-0.400,P=0.001),FEV1%(R=-0.395,P=0.001). AUC of MIF to distinguish AECOPD from sCOPD was 0.726,and AUC of MIF combined with CRP and PCT was 0.774. Conclusion There is an elevated serum MIF level in AECOPD patients,which is a candidate to distinguish AECOPD from sCOPD.
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