CD64指数在足月新生儿高胆红素血症的早期感染病因分析中的价值

Clinical diagnostic value of CD64 index for neonatal hyperbilirubinemia with early infection

目的探讨中性粒细胞表面CD64指数在新生儿高胆红素血症的病因分析和早期诊断的价值。方法回顾性分析我院2011年9月—2012年09月新生儿重症监护病房（NICU）收治的新生儿高胆红素血症病例223例，根据出院诊断分为细菌感染组和非细菌感染组，分析入院24h内CD64指数及超敏C反应蛋白（high—sensitivity—C—reactive protein，hsCRP）指标，根据受试者工作特征（receiver operating characteristic，ROC）曲线确定CD64指数的最佳临界值。结果细菌感染组与非细菌感染组CD64指数分别为0．29±0．08和0．11±0．06。2组CD64指数比较差异有统计学意义。细菌感染组hsCRP（2．06±1．71）ms／L，非细菌感染组hsCRP（1．11±0．93）ms／L，差异有统计学意义。绘制ROC曲线，CD64指数曲线下面积为0．946，hsCRP曲线下面积为0．692，CD64指数诊断细菌感染的灵敏度、特异度较hsCRP明显增高。结论CD64指数检测对足月新生儿高胆红素血症早期感染因素的诊断价值较高。

Objective To explore the clinical diagnostic value of neutrophil CD64 index in neonatal hyperbilimbinemia. Methods The clinical data of 223 cases of neonatal hyperbilimbinemia who received treatment in neonatal intensive care unit （NICU） in our hospital from September 2011 to September 2012 were retrospectively analyzed. According to discharge diagnosis, these patients were divided into bacterial infection group （n = 139） and non- bacterial infection group （n = 84）. The levels of CI）64 index and high -sensitivity C -reactive protein （hsCRP） in were measured within 24 h after hospitalization. The optimal critical value for CI）64 index was determined according to receiver operating characteristic （ROC） curve, Results The expressions of CD64 index （0. 29 ±0.08 vs. 11 ±0.06） and hsCRP [ （2.06 ± 1.71） mg/L vs. （1.11 ±0.93） mg/L] in bacterial infection group were significantly higher than in non - bacterial infection group. The area under curve of CD54 index and hsCRP were 0. 946 and 0.692, respectively. The sensitivity and specificity of CD64 index were 95.0% and 72..9%, respectively. Conclusions The expressions of neutrophil CD64 index and hsCRP in peripheral blood were increased significantly in neonatal hyperbilirubinemia with bacterial infection. CD64 is a better diagnostic marker for early bacterial infection in neonatal hyperbilirubinemia, with significantly better diagnostic performance than hsCRP.