烧伤脓毒症患者治疗前后中性粒细胞表面分子CD64与C-反应蛋白的变化和意义

目的：探究烧伤脓毒症患者治疗前后中性粒细胞表面分子CD64表达水平与C-反应蛋白（CRP）水平的变化及临床意义。方法：选择48例重度以上烧伤患者,分为脓毒症组（28例）和对照组（20例）,两组病人外周血中性粒细胞表面分子CD64值通过流式细胞仪检测,同时检测CRP水平。对以上参数进行组间比较,并通过受试者工作特征（ROC）曲线比较CD64及CRP诊断烧伤脓毒症的价值。脓毒症组治疗2周后再测CD64和CRP,比较治疗前后的变化。结果：脓毒症组CD64的表达为（88.96±12.73）%,明显高于非感染组（23.35±21.87）%（P〈0.01）。脓毒症患者CRP水平（97.73±53.29）mg/L明显高于对照组（27.20±17.99）mg/L（P〈0.01）。脓毒症组经治疗2周后CD64（24.40±18.67）%和CRP（42.61±16.61）mg/L,较治疗前有明显下降（P〈0.01）。通过ROC曲线比较,得出CD64较CRP诊断烧伤脓毒症更为敏感。结论：烧伤脓毒症患者CD64、CRP水平可作为诊断烧伤脓毒症的敏感指标,而CD64比CRP更为敏感。

CHANGE AND CLINICAL SIGNIFICANCE OF CD64 AND CRP OF THE BURN PYAEMIA BEFORE AND AFTER TREATMENTS

Objective：To research the expression and clinical significance of CD64 on the surface neutral granular cell and CRP of the burn pyaemia before and after treatments.Methods：Fouty-eight severity patients were divided into pyaemia（treatment） and control groups.There were 28 patients in treatment group,and 20 ones in control group.CD64 was detected by flow Cytometer（FCM） in 48 h after admission and CRP was detected at the same time.The results between CD64 and CRP were compared and the ROC curve was used to analysis the value of the parameters in diagnosis of pyeamia.CD64 and CRP in treatment group were detected again 2 weeks later after treatments and the changes were compared.Results：The mean value of CD64（88.96±12.73）% and CRP（97.73±53.29）mg/L in treatment group was higher than that in control group（23.35±21.87）% and（27.20±17.99） mg/L（P0.01）;respectively.The value of CD64（24.4±18.67）% and CRP（42.61±16.61） mg/L in treatment group decreased obviously after 2 weeks＇ treaetments.CD64 was more sensitive than CRP by ROC.Conclusion：Both the change of CD64 and CRP in the burned patients may be considered as sensitive indexes to diagnosis the pyaemie,but CD64 is more sensitive than CRP.