CD64在感染性疾病中诊断价值的研究

Diagnosis significance of determination of neutrophil CD64 mean fluorescence intensity index within infection diseases

目的应用流式细胞术测定外周血粒细胞表面CD64表达强度,评价CD64在诊断细菌感染性疾病中的实用价值。方法将100名研究对象分为4组,即细菌感染组、病毒感染组、真菌性感染组和正常对照组。使用流式细胞术、免疫浊度法分别检测外周血中性粒细胞CD64和C反应蛋白(CRP)水平。结果细菌性感染组患者外周血CD64指数(11.10±5.98)明显高于正常对照(2.976±0.807),差异有统计学意义(F=3.125,P<0.05);病毒感染组患者CD64指数(3.175±0.801)和真菌感染组患者CD64指数(3.780±0.896)明显低于细菌感染组;12例细菌感染患者抗生素治疗前CD64指数(12.981±4.525)明显高于治疗后(7.754±2.978),差异有统计学意义(t=4.182,P<0.01)。结论中性粒细胞CD64指数可以以作为诊断细菌感染的敏感指标,特别是对败血症的诊断更有价值,其敏感性和特异性均明显优于C反应蛋白。

Objective Using flow cytometry to detect circulating granulocytes surface CD64 mean fluorescence intensity index （ CD64 index） ,and evaluate the practical value of CD64 in diagnosis of bacterial infection. Methods 100 subjects were classified into four groups：bacterial infection, viral infection, fungal infection and healthy control. The levels of the in- dex of CD64, C reaction protein （CRP） in the peripheral blood were measured by automatic flow cytometry and immunoturbi- dimetry. Results The index of CD64 in the peripheral blood in bacterial infection group （ 11. 1029 ± 5. 983 ） was signifi- cantly higher than that in the healthy control group { 2.976 ±0. 807 } [ P 〈 0.05 ） ; index of CD64 in viral infection group { 3. 175±0. 801 ） and fungal infection group{3. 780 ±0. 896} were significantly lower than bacterial infection group; according to the ROC curve , the best threshold in diagnosis of infection was 3.63 with the sensitivity of 96.1% and the specificity of 90.2% ,which is notably advanced than CRP; The index of CD64 index in the pre treatment group（ 12. 981 ±4.525 } was higher than that in the post treatment group （ 7. 754±2. 978 ） （ P 〈 0.01 ） in 11 cases of infectious patients, implicated that the dynamic monitoring of CD64 index may assist in the treatment evaluation. Conclusion Neutrophil surface CD64 index may be a sensitive index for diagnosing bacterial infection, especially sepsis, which sensitivity and specificity are superior to CRP.