中性粒细胞CD64指数检测对AECOPD抗生素应用的指导价值

Value of neutrophil CD64 index in guiding the therapy for acute exacerbation of chronic obstructive pulmonary disease

目的评价中性粒细胞CD64指数在指导慢性阻塞性肺疾病急性加重期(AECOPD)抗感染治疗中的价值。方法入选60例AECOPD患者,随机分成CD64组(n=36)和常规治疗组(n=24)。CD64组根据血清中性粒细胞CD64指数决定抗生素的使用,如CD64指数≤4.0停用抗生素;常规治疗组根据患者入院时临床症状决定是否使用抗生素。主要观察指标为抗生素的使用天数、抗生素使用率、住院时间、临床有效率以及死亡率。结果 CD64组的抗生素使用多在7至10 d;而常规治疗组大部分在2周或者更长,差异有统计学意义(P<0.05);两组患者抗生素使用率以及住院天数差异具有统计学意义(P<0.01);临床有效率以及死亡率差异无统计学意义(P>0.05)。结论中性粒细胞CD64指数对指导AECOPD抗菌治疗具有重要的作用,可有效减少抗生素过度使用,缩短住院时间。

Objective To evaluate the value of CD64 index in the therapy of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods 60 patients with AECOPD were selected ,which were randomly assigned into CD64 group（ n = 36 ）and the con- ventional therapy group（ n = 24）. For patients in CD64 group,the use of antibiotics was based on CD64 index, antibiotics were stopped when CD64 index was not more than 4.0, and the use of antibiotics was based on clinical symptoms of patients in conventional treatment group. The main observation indexes included the days of antibiotics use, hospitalization days, rate of antibiotics use, clinical efficacy and mortality. Results The length of antibiotics exposure in CD64 group was 7 - 10 days, while it was two weeks or longer for patients in the conventional therapy group. In both groups, hospitalization days were significantly different. The clinical efficacy and mortality had no sig- nificant difference. Conclusion CD64 index in AECOPD can reduce the excessive use of antibiotics and the length of hospitalization.