烧伤患者感染与CD64^+中性粒细胞相关性的初步研究

Correlation study between CD64^+ neutrophils and infection of patients with burns

目的目前关于烧伤患者感染体外相关指标研究较少,文中旨在探讨烧伤并发感染患者早期外周血CD64^+中性粒细胞变化情况及体外增殖情况。方法选取广西医科大学第一附属临床医学院烧伤科患者86例,其中并发感染患者44例为试验组,未发生感染患者42例为体内对照组。从健康人外周血中分离出CD64^+中性粒细胞,在体外用已灭活的金黄色葡萄球菌对其进行刺激使其增殖,模拟感染发生作为体外实验组,体外对照组加入相同体积PBS。MODFIT 2软件进行增殖指数的分析。检测其外周血中WBC含量及中性粒细胞中CD64^+细胞比例,通过ROC曲线进行特异性和敏感性分析。结果在体外增殖实验中,实验组CD64^+细胞平均增殖指数(6.48±0.11)明显高于对照组(2.63±0.02),差异有统计学意义(P<0.05)。试验组患者外周血中CD64^+中性粒细胞比例明显高于体内对照组[(64.25±13.11)%vs(16.33±2.77)%,P<0.05]。ROC曲线显示CD64诊断烧伤并发感染的敏感性和特异性均优于WBC(94.2%vs 68.5%,76.8%vs 64.7%,P<0.05)。结论烧伤并发感染患者外周血中CD64^+细胞明显增多,可以作为烧伤患者并发感染时早期监测的指标。

Objective The in vitro studies of indicators in burn patients with complicated infection have been little studied till now. So this study aims to investigate the change of proliferation of CD64~＋neutrophils from the peripheral blood of burn patients in vitro. Methods CD64~＋neutrophils from peripheral blood of healthy people were isolated and purified,which was followed by stimulating its proliferation with inactivated Staphylococcus in vitro. We further analyzed the proliferation index with Modfit 2 analysis software. 86 burn patients were divided into two groups,44 cases with complicated infection assigned to experimental group,42 uninfected assigned to controls. We further detect the counts of WBC and the percentage of CD64~＋neutrophils,and then analyzed the specificity and sensitivity by using the receiver operating characteristic（ ROC） curves. Results This in vitro study,the average proliferation index of CD64~＋cells in experimental wells was significantly higher than controls（ 6. 48 ± 0. 11 vs 2. 63 ± 0. 02）,the difference was statistically significant（ P 0. 05）; the percentage of CD64~＋cells in the peripheral blood of patients in experimental group（ 64. 25 ±13. 11%） was significantly higher than patients without infection（ 16. 33 ± 2. 77%）; The sensitivity and specificity of diagnostic method of CD64~＋cells for the burn infection were respectively 94. 2% and 76. 8%,which was superior to the traditional diagnostic method of WBC（ 68. 5%,64. 7%） according to ROC curves.Conclusion CD64~＋cells in peripheral blood of burn patients complicated by infection increased more significantly and earlier when compared with the traditional diagnostic method,which may be used as a useful diagnostic indicator for burns complicated infection.