中性粒细胞CD64百分比在重症细菌感染性疾病中的诊断意义

The diagnostic value of percentage of neutrophil CD64+ in severe bacterial infectious diseases

目的探讨中性粒细胞CD64在重症细菌感染疾病诊断中的应用价值。方法选取该院82例患者,分为感染组和健康对照组,采用流式细胞术检测中性粒细胞CD64表达水平[以CD64(MFI)和CD64(%)表示],同时行外周静脉血白细胞计数(WBC)、中性粒细胞比率(Neu%)、C反应蛋白(CRP)、降钙素原(PCT)检测。结果 CD64(MFI)与PCT、CRP水平密切相关(r=0.201 8,P<0.01;r=0.113 5,P<0.05),CD64(%)也与PCT、CRP显著相关(r=0.181 1,P<0.01;r=0.135 9,P<0.05);CD64(MFI)诊断细菌感染的敏感度85.42%,特异度79.36%,CD64(%)的敏感度89.96%,特异度82.20%,受试者工作特征(ROC)曲线表明CD64(%)诊断感染时与CD64(MFI)优势相当;在重症感染组中,CD64(%)诊断曲线下面积高于CD64(MFI)。结论中性粒细胞CD64表达可作为细菌感染性疾病的诊断及判断病情的可靠指标,且中性粒细胞CD64(%)在重症感染的诊断效能优于CD64(MFI)。

Objective To investigate the value of CD64 in severe bacterial infection diseases diagnosing.Methods Totally 82 patients were chosen and divided into two groups,infected group（n=60）and healthy control（n=22）.Flow cytometry was used to detect the expression of CD64[CD64（MFI）and CD64（%）],peripheral blood leukocyte（WBC）,neutrophil percentage（Neu%）,C-reactive protein（CRP）and procalcitonin（PCT）.Then the sensitivity and specificity of these indexes were evaluated.ResultsCD64（MFI）was positively correlated with PCT and CRP（r=0.201 8,P〈0.01;r=0.113 5,P〈0.05）,and CD64（%）was also positively correlated with PCT and CRP（r=0.181 1,P〈0.01;r=0.135 9,P〈0.05）.The sensitivity and specificity of CD64（MFI）in diagnosing bacterial infection diseases were 85.42% and 79.36%,and the sensitivity and specificity of CD64（%）were89.96% and 82.20%.ROC results showed the diagnostic value of CD64（MFI）and CD64（%）was generally similar in infected diseases,while in severe infection groups,the area under the curve of CD64（%）was higher than that of CD64（MFI）.ConclusionThe expression of CD64 on neutrophil cell can serve as markers for diagnosing bacterial infection diseases,and neutrophil CD64（%）in the diagnosis of severe infection efficiency is better than that of CD64（MFI）.