CD64、降钙素原、血清淀粉样蛋白A及C反应蛋白在急性感染性疾病中的诊断价值

目的 探讨CD64、降钙素原(PCT)、血清淀粉样蛋白A(SAA)及C反应蛋白(CRP)联合检测在急性感染性疾病中的临床诊断价值.方法分别检测241例细菌感染者、162例病毒感染者和144名健康人的CD64、PCT、SAA及CRP.利用ROC曲线评价PCT、CRP、PCT及SAA的诊断价值.结果 细菌感染组CD64为(17.77±6.18)MFI、SAA为(179.37±116.56) mg/L、PCT为(1.22±0.39) ng/mL、CRP为(51.03±34.34) mg/L;急性病毒感染组分别为(9.85±2.69) MFI、(122.14±101.58) mg/L、(0.13±0.08) ng/mL和(15.62±13.04) mg/L;健康对照组分别为(9.35±2.16) MFI、(5.55±3.36)mg/L、(0.11±0.05) ng/mL、(3.93±2.77) mg/L;CD64、SAA、PCT和CRP在3组间的差异有统计学意义(F=59.449、32.710、31.531和34.439,P均＜0.01);SAA对急性病毒感染的曲线下面积为0.812,诊断灵敏度为0.783,诊断价值高于CRP.CD64对急性细菌感染的曲线下面积为0.882,诊断灵敏度为0.908,诊断价值优于PCT.4个参数联合检测对急性细菌感染的曲线面积为0.941,诊断灵敏度为0.983,对急性病毒感染曲线下面积为0.850,诊断灵敏度为0.800.结论 SAA是在判断感染特别是病毒感染方面明显优于CRP,CD64表达在细菌感染诊断上优于PCT.SAA、CRP、CD64和PCT联合检测对细菌感染和病毒感染鉴别诊断效能优于单独检测.

Diagnostic value of CD64, procalcitonin,serum amyloid A protein and C-reactive protein in acute bacterial and viral infectious diseases

Objective To evaluate the clinical diagnostic value of the combined detection of CD64,serum amyloid A protein (SAA),procalcitonin (PCT) and C-reactive protein (CRP) for acute infectious diseases.Methods CD64,SAA,PCT and CRP were detected in 241 patients with bacterial infection,162 patients with viral infection and 144 healthy controls,respectively.The diagnosis value of CD64,PCT,SAA and CRP were analyzed by ROC curve.Results In bacterial infection group,CD64,SAA,PCT and CRP were (17.77±6.18) MFI,(179.37±116.56) mg/L,(1.22±0.39) ng/mL and (51.03±34.34) mg/L,respectively.In viral infection group,CD64,SAA,PCT and CRP were (9.85±2.69) MFI,(122.14±101.58) mg/L,(0.13±0.08) ng/mL and (15.62± 13.04) mg/L,respectively.In healthy control group,CD64,SAA,PCT and CRP were (9.35±2.16) MFI,(5.55± 3.36) mg/L,(0.11±0.05) ng/mL and (3.93±2.77) ng/mL,respectively.The different levels of CD64,SAA,PCT and CRP were statistically significant in 3 groups (F=59.449,32.710,31.531 and 34.439,P all ＜0.01).The area under ROC curve of SAA was 0.812 to diagnose acute viral infection,and the sensitivity was 0.783.The diagnostic value was better than CRP.The area under ROC curve of CD64 was 0.882 to diagnose acute bacterial infection,and the sensitivity was 0.908.The diagnostic value was better than PCT.The area under ROC curve of the four index combined detection was 0.941 to diagnose acute bacterial infection,and the sensitivity was 0.983.The area under ROC curve of the four index combined detection was 0.850 to diagnose acute viral infection,and the sensitivity was 0.800.Conclusions SAA is better than CRP in diagnosing viral infection,while CD64 is better than PCT in diagnosing the bacterial infection.To diagnose bacterial infection or viral infection,the combined detection of CD64,SAA,PCT and CRP is better than respective detection.