血清淀粉酶A蛋白、中性粒细胞表面抗原CD64在新生儿败血症中的诊断价值

Evaluation of SAA and CD64 in early diagnosis of neonatal septicemia

目的探讨血清淀粉酶A蛋白(SAA)、中性粒细胞表面抗原CD64在新生儿败血症诊断及疗效评价中的价值。方法 2011年5月至2012年5月住院并疑为感染的80例新生儿,分为败血症组35例,非败血症感染组45例;另设对照组20例。检测各组入院时,以及败血症组在治疗1周后的SAA、CD64水平,各组间进行比较,并分析SAA、CD64诊断败血症的敏感性和特异性。结果败血症组和非败血症感染组CD64、SAA均明显高于对照组,差异有统计学意义(P<0.01);败血症组CD64水平高于非败血症感染组,差异亦有统计学意义(P<0.01)。败血症组经抗感染治疗1周后CD64及SAA水平均较治疗前下降,差异有统计学意义(P均<0.01)。以CD64≥2 943个荧光抗体分子/细胞、SAA≥5.3 mg/L、CRP≥8 mg/L为阳性标准,CD64诊断败血症的敏感性和特异性分别为91.43%、90.00%均较SAA及CRP高。结论中性粒细胞表面抗原CD64是早期诊断新生儿败血症的灵敏指标之一。

Objectives To investigate the value of serum amyloid A （SAA） and neutrophils cell surface antigen 64 （CD64） in the early diagnosis of neonatal septic＇emia. Methods Eighty neonates in a neonatal ward between May 2011 and May 2012 were divided into sepsis group （n=35） and non-septicemic infection group （n=45）. Twenty hospitalized neonates with non- infectious diseases were enrolled as controls （n=20）. SAA and CD64 were measured upon admission and during the recovery period （1 week post-treatment） and their sensitivity and specificity were analysed. Results The expressions of CD64 and SAA were significantly higher in sepsis group and non-septicemic infection group than those in control group （P〈0.01）. The expres- sion of CD64 was significantly higher in sepsis group than that in non-septicemic infection group （P〈0.01）. The expressions of CD64 and SAA were significantly decreased in sepsis group 1 week after treatment as compared to before treatment （P〈0.01）. When the cutoff values for CD64, SAA and CRP were 2943 molecules/cell, 5.3 mg/L and 8 mg/L, CD64 had higher diagnos- tic sensitivity and specificity for sepsis （91.43% and 90.00%） than SAA and CRE Conclusions CD64 is a sensitive indicator for the early diagnosis of neonatal septicemia.