中性粒细胞CD64对血液疾病患者发生细菌感染的诊断效果

Effect of CD64 on the diagnosis of bacterial infection in patients with hematological diseases

目的探讨中性粒细胞CD64对血液疾病患者细菌感染的临床诊断效果。方法 55例血液病患者和51例非血液病患者根据是否发生细菌感染分为血液病感染组（39例）、血液病非感染组（16例）、非血液病感染组（36例）、非血液病非感染组（15例）,检测所有患者的CD64、降钙素原（PCT）、C反应蛋白（CRP）、白细胞（WBC）计数,并建立受试者工作特征曲线（ROC）,计算其灵敏度与特异度。结果血液病感染组患者CD64阳性指数、PCT、CRP水平显著高于血液病非感染组,差异有统计学意义（P〈0.05）,WBC计数差异无统计学意义（P〉0.05）。非血液病感染组患者CD64阳性指数、PCT、CRP水平与WBC计数显著高于非血液病非感染组,差异有统计学意义（P〈0.05）。血液病患者CD64阳性指数的ROC曲线下面积为0.973,95%CI为0.727-0.998,灵敏度为0.973,特异度为0.947;非血液病患者CD64阳性指数的ROC曲线下面积为0.942,95%CI为0.853-0.984,灵敏度为0.894,特异度为0.863。恶性与非恶性血液病感染患者CD64阳性指数、PCT、CRP水平与WBC计数之间的差异无统计学意义（P〉0.05）。结论中性粒细胞CD64能够作为血液疾病患者细菌感染的诊断指标,对血液病患者细菌感染的早期诊断与治疗具有重要的临床意义。

Objective To explore the effect of CD64 in the diagnosis of bacterial infection in patients with hematological diseases.Methods 55 cases of patients with hematological disease and 51 cases of patients without hematological disease were divided into blood disease infection group（39cases）,blood disease non infection group（16cases）and non blood disease infection group（36cases）and non blood disease in non infection group（15cases）due to the occurrence of bacterial infection.CD64,calcitonin peptide（PCT）,C-reactive protein（CRP）and white blood cell count were all detected,and receiver operating characteristic curve（ROC）was established that,calculated the sensitivity and specificity.Results CD64 positive index,PCT and CRP levels in Blood disease infection group were significantly higher than those in blood disease of non infection group and the difference had statistical significance（P〈0.05）,while white blood cell count had no statistical significance between them（P〉0.05）.The CD64 positive index,PCT level,CRP level and the number of white blood cell count were significantly higher than those in non infected group and the difference was statistically significant（P〈0.05）.CD64 positive index of blood disease group under ROC curve was 0.973,in addition,95%CI,sensitivity and specificity were respectively 0.727-0.998,0.973and0.947;CD64positive index of ROC curve area in non hematological disease group was 0.942 and 95%CI,sensitivity and specificity were respectively 0.853-0.984,0.894 and 0.863.There was no significant difference between CD64 positive index,PCT level,CRP level and the number of white blood cell count in malignant and non malignant hematological diseases（P〉0.05）.Conclusion CD64 can be used as a diagnostic indicator of bacterial infection in patients with hematological diseases and it has important clinical significance for early diagnosis and treatment of bacterial infections in patients with hematologic diseases.