外周血中性粒细胞表面分子CD64的表达及C-反应蛋白的变化对烧伤感染患者诊断的临床意义

发布时间：2018-05-16 19:45

本文选题：烧伤感染 + CD64　；参考：《广西医科大学》2013年硕士论文

【摘要】：目的：探讨外周血中性粒细胞表面分子CD64的表达和C-反应蛋白(CRP)的变化对烧伤感染患者严重程度的早期诊断及其临床价值。方法：128例烧伤住院患者,分为对照组66例和感染组62例(其中脓毒症组30例,局部感染组32例)。在入院治疗前后分别抽取各组患者外周静脉血2.5ml,采用流式细胞仪检测中性粒细胞表面分子CD64的表达水平,同时检测外周血CRP、中性粒细胞的百分比(Neu%)及白细胞计数(WBC)。对其进行相关分析并用Logistic回归筛选相关指标建立回归方程,同时采用ROC曲线对其临床特性进行分析。结果：感染组CD64、CRP的表达显著高于对照组,差别有统计学意义(P0.001)；对感染组(即脓毒症组+局部感染组)进行相关分析显示：CD64的表达与CRP呈正相关(r=0.455,t=3.961、P0.001)；感染组中脓毒症组CD64、CRP的表达水平显著高于局部感染组,说明两者的表达水平与感染的严重程度密切相关,即感染的程度越重,两者的表达水平越高；感染组治疗后CD64及CRP表达水平较治疗前显著下降(P0.001),但仍未降到正常水平,与对照组治疗前比较差别有统计学意义(P0.001)。建立回归方程Y=-6.891+3.159X1+4.272X2,同时进行ROC曲线分析,新变量Y、CRP、CD64、Neu%和WBC计数,5种指标的敏感性分别为96.80%、91.90%、95.20%、83.90%、85.50%,特异性分别为87.90%、83.30%、81.80%、71.30%、65.20%。结论：检测烧伤感染患者外周血中性粒细胞表面分子CD64的表达水平及CRP的变化,可作为早期诊断烧伤感染严重程度的敏感指标,同时运用Logistic回归和ROC曲线综合分析可提高诊断的敏感性和特异性,对烧伤感染患者治疗效果的评价具有重要的临床意义。
[Abstract]:Objective: to investigate the expression of CD64 on the surface of peripheral blood neutrophils and the changes of C-reactive protein (CRP) in the early diagnosis and clinical value of burn infection. Methods 128 burn inpatients were divided into control group (n = 66) and infection group (n = 62) (sepsis group (n = 30) and local infection group (n = 32). The peripheral venous blood of each group was extracted at 2.5 ml before and after admission. The expression of CD64 on the surface of neutrophils was detected by flow cytometry, the percentage of neuter in peripheral blood and the white blood cell count were also detected. The correlation analysis was carried out and the regression equation was established by Logistic regression, and the clinical characteristics were analyzed by ROC curve. Results: the expression of CD64 CRP in infected group was significantly higher than that in control group. The correlation analysis between infection group (local infection group) showed that there was a positive correlation between CRP and CD64 expression in sepsis group, and the expression level of CD64 in sepsis group was significantly higher than that in local infection group, and the expression of CD64 protein in sepsis group was significantly higher than that in local infection group, and there was a positive correlation between the expression of CD64 and CRP in sepsis group, and the expression of CD64hCRP in sepsis group was significantly higher than that in local infection group. The results showed that the expression level of CD64 and CRP in the infected group was significantly lower than that before treatment, but the expression level of CD64 and CRP in the infected group was not reduced to the normal level, which was closely related to the severity of infection, that is, the higher the degree of infection was, the higher the expression level of both of them was, and the expression level of CD64 and CRP in the infected group decreased significantly after treatment. Compared with the control group before treatment, the difference was statistically significant (P 0.001). The regression equation was established and the ROC curve was analyzed. The sensitivity of the new variable was 96.8091.9091.9091.90 and 83.900.The specificity was 87.9083.300.The specificity was 81.300.71.300.The sensitivity of the new variable was 71.300.The sensitivity was 65.200.The sensitivity of the new variable was 96.800.91.90 and 83.900.The specificity was 87.9083.300.The sensitivity of the new variable was 71.300.The sensitivity of the new variable was 65.20%. Conclusion: detecting the expression of CD64 and the change of CRP in peripheral blood neutrophils of burn infected patients can be used as a sensitive index for the early diagnosis of burn infection severity. At the same time, Logistic regression and ROC curve analysis can improve the sensitivity and specificity of the diagnosis, and it is of great clinical significance to evaluate the therapeutic effect of burn infection patients.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7;R644

【参考文献】