中性粒细胞CD64百分比在重症细菌感染性疾病中的诊断意义

目的探讨中性粒细胞CD64在重症细菌感染疾病诊断中的应用价值。方法选取该院82例患者,分为感染组和健康对照组,采用流式细胞术检测中性粒细胞CD64表达水平[以CD64(MFI)和CD64(%)表示],同时行外周静脉血白细胞计数(WBC)、中性粒细胞比率(Neu%)、C反应蛋白(CRP)、降钙素原(PCT)检测。结果 CD64(MFI)与PCT、CRP水平密切相关(r=0.201 8,P0.01;r=0.113 5,P0.05),CD64(%)也与PCT、CRP显著相关(r=0.181 1,P0.01;r=0.135 9,P0.05);CD64(MFI)诊断细菌感染的敏感度85.42%,特异度79.36%,CD64(%)的敏感度89.96%,特异度82.20%,受试者工作特征(ROC)曲线表明CD64(%)诊断感染时与CD64(MFI)优势相当;在重症感染组中,CD64(%)诊断曲线下面积高于CD64(MFI)。结论中性粒细胞CD64表达可作为细菌感染性疾病的诊断及判断病情的可靠指标,且中性粒细胞CD64(%)在重症感染的诊断效能优于CD64(MFI)。

The diagnostic value of percentage of neutrophil CD64 + in severe bacterial infectious diseases

Objective To investigate the value of CD64 in severe bacterial infection diseases diagnosing .Methods Totally 82 pa‐tients were chosen and divided into two groups ,infected group (n= 60) and healthy control (n= 22) .Flow cytometry was used to detect the expression of CD64[CD64 (MFI) and CD64 (% )] ,peripheral blood leukocyte (WBC) ,neutrophil percentage (Neu% ) , C‐reactive protein (CRP) and procalcitonin(PCT ) .Then the sensitivity and specificity of these indexes were evaluated .Results CD64(MFI)was positively correlated with PCT and CRP (r = 0 .201 8 ,P < 0 .01 ;r = 0 .113 5 ,P < 0 .05) ,and CD64(% ) was also positively correlated with PCT and CRP (r = 0 .181 1 ,P < 0 .01 ;r = 0 .135 9 ,P < 0 .05) .The sensitivity and specificity of CD64 (MFI) in diagnosing bacterial infection diseases were 85 .42% and 79 .36% ,and the sensitivity and specificity of CD64(% ) were 89 .96% and 82 .20% .ROC results showed the diagnostic value of CD64 (MFI) and CD64 (% ) was generally similar in infected diseases ,while in severe infection groups ,the area under the curve of CD64 (% ) was higher than that of CD64 (MFI) .Conclusion The expression of CD64 on neutrophil cell can serve as markers for diagnosing bacterial infection diseases ,and neutrophil CD64 (% ) in the diagnosis of severe infection efficiency is better than that of CD64 (MFI) .