CD64与G实验联用在诊断侵袭性真菌感染中的检测价值分析

Analysis for the detection value of CD64 levels combined with G test in diagnosis of invasive fungal infections

目的观察和分析全血中性粒细胞CD64与血浆G实验联合检测在诊断侵袭性真菌感染(IFI)中的价值。方法选取100例疑似IFI住院患者作为研究对象,根据是否被最终诊断为IFI将其分为病例组(41例)和对照组(59例),对2组患者全血中性粒细胞CD64水平和G实验[血浆(1,3)-β-D葡聚糖]水平进行观察和比较。结果病例组患者全血中性粒细胞CD64水平显著高于对照组(t=5.564,P<0.01),全血中性粒细胞CD64检测诊断IFI的受试者工作特征曲线下面积为0.782;全血中性粒细胞cd64检测与G实验检测结果具有相关性(χ2=72.074,P<0.01),诊断IFI的Kappa值为0.848(t=8.490,P<0.01),Mc Nemar检验结果显示P=0.688;单独应用全血中性粒细胞CD64检测与单独应用G实验检测的敏感性均显著低于联合检测(χ2=6.011、10.818,P<0.05),三种方法诊断IFI的特异性差异无统计学意义(χ2=1.883,P>0.05)。结论全血中性粒细胞CD64检测在诊断IFI中具有一定的价值,联合应用全血中性粒细胞CD64检测和G实验可提高针对IFI的诊断敏感性。

Objective To observe and analyze the detection value of CD64 levels in whole blood neutrophilic granulocytes,combined with plasma G test in diagnosis of invasive fungal infections（ IFI）. Methods One hundred patients with suspected IFI were served as research objects and were divided into case group（ n = 41） and control group（ n = 59）according to whether they were eventually diagnosed as IFI or not. The CD64 levels of neutrophilic granulocytes and G test[plasma（ 1,3） β-Dglucosans]of the patients were observed and compared between two groups. Results The CD64 levels in whole blood neutrophilic granulocytes in case group were significantly higher than those in control group（ t = 5. 564,P〈0. 01）. The area under the receiver operating characteristic curve of patients with IFI diagnosed by detecting CD64 levels of whole blood neutrophilic granulocytes was 0. 782. There was a correlation between CD64 detection and G test（ χ2= 72. 074,P〈0. 01）,moreover,Kappa number in diagnosis of IFI was 0. 848（ t = 8. 490,P〈0. 01）,and Mc Nemar＇s test showed P = 0. 688. The sensitivity of single application of CD64 detection or G test detection was significantly lower than that of combined detection（ χ2= 6. 011,10. 818,P〈0. 05）. There was no significant difference in the specificity of diagnosis of IFI among the three kinds of methods（ χ2= 1. 883,P〈0. 05）. Conclusion The CD64 detection in whole blood neutrophilic granulocytes has a certain value in the diagnosis of IFI. Moreover the combined detection of CD64 levels with G test can improve the sensitivity in diagnosis of IFI.