中性粒细胞CD64表达在重症患者感染中的意义

发布时间：2018-03-31 23:15

本文选题：中性粒细胞　切入点：CD指数　出处：《免疫学杂志》2015年09期

【摘要】：目的探讨外周血中性粒细胞CD64的表达在重症患者感染诊断及疗效评价中的价值。方法以2013年10月至2014年9月在本院重症监护病房(ICU)住院的感染患者103例为研究对象,对照组为健康体检者25例。根据临床表现和细菌学检测结果,将重症合并感染患者分成细菌感染组(86例)、真菌感染组(9例)和病毒感染组(8例)。应用流式细胞术检测中性粒细胞CD64表达,同时检测外周血C反应蛋白(CRP)及白细胞(WBC)水平,分析各组患者之间这3个指标的差异,并对17例细菌性感染的患者抗生素治疗前后CD64指数进行比较。绘制受试者工作特征(ROC)曲线,计算CD64指数最佳临界值,同时对CRP、WBC及CD64指数的敏感度与特异度进行比较。结果细菌性感染组患者外周血CD64指数(3.416±1.854)明显高于正常对照组(1.351±0.602)、真菌感染组(1.664±0.249)和病毒感染组(1.379±0.071)(P0.01);败血症组CD64指数(6.081±2.009)最高,且明显高于局部细菌感染组(2.853±1.234)(P0.01);17例细菌感染患者抗生素治疗后CD64指数(3.946±1.972)明显低于治疗前(5.849±2.185)(P0.05)。根据ROC曲线得出CD64指数具有较高的特异度(88%)和敏感度(86%),高于白细胞计数(84%,77.9%)和C反应蛋白(76%,83.7%)。结论流式细胞术检测中性粒细胞CD64指数可作为重症患者细菌感染的早期诊断、判断病情和评价治效果的可靠指标。
[Abstract]:Objective to investigate the expression of peripheral blood neutrophil CD64 in the evaluation of the diagnosis and treatment of patients with severe infection in value. From October 2013 to September 2014 in our hospital ICU (ICU) infection in hospitalized patients 103 cases as the research object, the control group of 25 healthy persons. According to clinical and bacteriological detection results. The serious patients with infections were divided into bacterial infection group (86 cases), fungal infection group (9 cases) and viral infection group (8 cases). To detect the expression of CD64 on neutrophils by flow cytometry, and the detection of peripheral blood C reactive protein (CRP) and white blood cell (WBC) level, difference analysis in between these 3 indicators, and the patients before and after antibiotic treatment of bacterial infection in 17 cases of CD64 index were compared. The receiver operating characteristic (ROC) curve, CD64 index calculation of the optimal threshold, while the CRP, WBC and CD64 index sensitivity and To compare the specificity. Results the bacterial infection group in peripheral blood of patients with CD64 index (3.416 + 1.854) was significantly higher than the normal control group (1.351 + 0.602), fungal infection group (1.664 + 0.249) and viral infection group (1.379 + 0.071) (P0.01); sepsis group CD64 index (6.081 + 2.009) highest. And was significantly higher than local bacterial infection group (2.853 + 1.234) (P0.01); CD64 index of antibiotics in 17 patients with bacterial infection after treatment (3.946 + 1.972) was significantly lower than that before treatment (5.849 + 2.185) (P0.05). According to the ROC curve of CD64 index has a high specificity (88%) and sensitivity (86%) that is higher than that of white blood cell count (84%, 77.9%) and C reactive protein (76%, 83.7%). Conclusion the flow cytometric detection of neutrophil CD64 index can be used as the early diagnosis of bacterial infection in patients with severe, reliable index to judge the condition and the evaluation of treatment effect.

【作者单位】：皖南医学院弋矶山医院中心实验室;皖南医学院弋矶山医院重症医学科;
【基金】：皖南医学院中青年科研基金(WK2012F22)
【分类号】：R51

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