CD64指数在恶性血液病患者感染性发热和非感染性发热中的鉴别诊断价值

Differential diagnosis between infective fever and non-infective fever by CD64 index in patients with hematological malignant diseases

目的 探讨外周血中性粒细胞CD64指数在恶性血液病患者感染性发热和非感染性发热中的鉴别诊断价值。方法 收集2012-07-2013-07血液科住院的恶性血液病合并发热患者98例,其中感染性发热组(包括细菌感染、真菌感染及混合感染,除外病毒感染)65例、非感染性发热组(包括肿瘤性发热、药物热等)33例,对照组30例为同时期住院的非恶性血液病患者。流式细胞仪检测所有受试者外周血中性粒细胞CD64指数的水平。结果 感染性发热组中性粒细胞CD64指数水平较对照组明显升高(3.24±0.42 vs 1.09±0.41,P<0.05),也较非感染性发热组(1.58±0.59)明显升高(P<0.05);与对照组相比,非感染性发热组中性粒细胞CD64指数水平则无明显升高(1.58±0.59 vs 1.09±0.41,P>0.05)。经过有效治疗2周后,感染性发热组中性粒细胞CD64指数(1.11±0.72)明显下降,与治疗前比较有统计学差异(P<0.05),而非感染性发热组中性粒细胞CD64指数(1.10±0.28)无明显下降,与治疗前比较无统计学差异(P>0.05)。结论 中性粒细胞CD64指数在恶性血液病患者感染性发热和非感染性发热的鉴别中具有一定价值。

Objective To evaluate the application of CD64 index in differential diagnosis between infective fever and non-infective fever in patients with hematological malignant diseases. Methods CD64 index in peripheral neutrophils was de- tected by flow cytometry in 98 hematological malignancy patients with fever, including 65 cases with infection （bacterial, fungal or mixed infection） and 33 non-infected patients （cancerous fever or drug fever）. Thirty non-malignancy patients served as con- trol group. Results The neutrophil CD64 index （3.24± 0.42） in infected group was higher than that in control group （1.09 ± 0.41） and in non-infected group （1.58 ± 0.59） （both, P〈0.05） . There was no significant difference in neutrophil CD64 index between non-infected group and control group （P 〉0.05）. After effective treatment CD64 index in infected group was significantly de- creased （3.24 ± 0.42 vs 1.11 ± 0.72, P〈0.05）, but not significantly decreased in non-infected group （1.58 ± 0.59 vs 1.10±0.28, P 〉0.05）. Conclusion The neutrophil CD64 index may be used for differential diagnosis between infected fever and non-in- fected fever in hematological malignancy patients.