呼吸道感染患者治疗前后的外周血中性粒细胞CD64、血清降钙素原、C-反应蛋白水平的变化

目的：分析呼吸道感染患者治疗前后外周血中性粒细胞CD64、血清降钙素原（PCT）、C反应蛋白（CRP）水平的变化。方法入选2012年11月～2013年10月我院收治的80例呼吸道感染患者，经临床诊断42例细菌感染者设为A组，38例病毒感染者设为B组，另外抽选40例健康者设为对照组。对A、B组患者进行常规治疗1周，于治疗前和治疗3 d、7 d时，分别用流式细胞术、免疫荧光分析法、快速免疫荧光法检测CD64、PCT、CRP 的表达变化，对三种方法所做出的结果作对比分析，比较其特异度与敏感度之间的差异。结果治疗前，A组CD64、PCT、CRP水平分别为（2611.5±252.4）MESF、（5.2±2.5） ng/mL、（60.5±13.4） mg/L，均明显高于B 组和对照组（均P＜0.05）；B组的CD64、CRP高于对照组（P＜0.05）；但是PCT与对照组比较，无明显差异（P＞0.05）。治疗7 d后，A组的CD64明显降低，细菌感染程度降低，PCT、CRP也分别降低，与治疗3 d比较差异显著（P＜0.05）；而B组CD64有降低趋势，而PCT、CRP 变化不明显（P＞0.05）。 CD64的灵敏度、特异性、诊断有效率分别为95.6%、92.4%、97.6%，均高于PCT和CRP（P＜0.05）；PCT和CRP间比较差异无统计学意义（P＞0.05）。结论呼吸道感染患者细菌性感染，CD64表达会升高，与呼吸道细菌性感染程度成正相关，特异度与敏感度均比CRP 高，与降钙素原比较不仅能更灵敏的反映疾病情况的严重程度，也能观察疗效，指导临床用药。

Changes of CD64, serum procalcitonin and C-reactive protein in periph-eral blood neutrophil of patients with respiratory tract infection before and after treatment

Objective To analyze the changes of CD64, serum procalcitonin and C-reactive protein in the peripheral blood neutrophil of patients with respiratory tract infection before and after treatment. Methods Eighty patients with respiratory tract infection were treated in our hospital from November 2012 to October 2013 , of which 42 cases clini-cally diagnosed by bacterial infection as group A , and 38 cases diagnosed by virus infection as group B ,and 40 healthy people selected as control group. Group A and group B were treated with routine treatment for 1 weeks. CD64 , PCT and CRP expression were detected by the methods of flow cytometry,immunofluorescence assay,and rapid immune fluorescence before and after treatment for 3 days and 7 days ,respectively.The differences of specificity and sensitivity were compared by analyzing the results of three methods. Results Before treatment,CD64, PCT, CRP levels of group A were （2611.5±252.4） MESF,（5.2±2.5） ng/mL, （60.5±13.4） mg/L, respectively, significantly higher than those of group B and control group （P〈0.05）; CD64 and CRP of group B were higher than those of control group （P〈0.05）;However, PCT compared with the control group, there was no significant difference （P〉0.05）. After treatment for 7 days, CD64 of group A decreased significantly, and the degree of bacterial infection decreased,as well as PCT and CRP compared with those after treatment for 3 days （P〈0.05）,and CD64 of group B showed a decreased trend, while PCT, CRP did not change significantly （P〉0.05）. The sensitivity,specificity and diagnostic efficiency of CD64 were 95.6%,92.4%,97.6%,respectively,was higher than those of PCT and CRP （P〈0.05）;But those between PCT and CRP had no significant difference （P〉0.05）. Conclusion CD64 expression of patients with bacterial infection of respiratory tract infection increased,and positively correlated with the respiratory tract bacterial infection rate,and specificity and sensitivity were higher than those of CRP.When