CD64指数与PCT、CRP联合检测在呼吸道感染疾病中的诊断价值

The diagnostic value of combined detection of CD64,PCT and CRP for respiratory tract infection diseases

目的探讨中性粒细胞CD64指数、降钙素原(PCT)、C-反应蛋白(CRP)对呼吸道细菌感染性疾病的诊断价值。方法采集已确诊的40例呼吸道细菌性感染患者血样和40例呼吸道病毒性感染患者血样做为实验组,40例经体检合格的健康者做对照组。应用流式细胞术检测CD64指数、免疫荧光法检测PCT、免疫散射比浊法检测CRP,并对其结果进行比对分析,应用受试者工作特征曲线(ROC曲线)分析三种指标在呼吸道细菌感染中的诊断价值。结果细菌感染组CD64指数、PCT、CRP指数均值均明显高于对照组(P<0.05),病毒感染组只有CRP与对照组差异有统计学意义(P<0.05)。细菌感染组中CD64指数、PCT、CRP阳性率均高于对照组,分别为75.0%、72.5%、55.0%,病毒感染组只有CRP阳性率高于对照组。ROC曲线显示:CD64指数、PCT和CRP曲线下面积分别是0.859、0.793、0.675;灵敏度分别是90.0%、88.0%、83.0%;特异度分别82.0%、78.0%、74.0%。结论 CD64指数、PCT、CRP均可作为检测呼吸道细菌感染性疾病的指标。CD64敏感性和特异性最高,CRP敏感性与特异性最低。CD64指数、PCT和CRP联合检测可显著提高呼吸道感染性疾病的诊断灵敏度和特异度,对诊断和鉴别诊断具有重要意义。

Objective To investigate the diagnostic significance of neutrophil CD64 index,procalcitonin（PCT）and C-reactive protein（CRP）for respiratory tract infection diseases.Methods The blood samples of 40 patients with respiratory tract bacterial infections and 40 ones with respiratory viral infection were selected as the experimental groups,with 40 healthy people as the control group.Flow cytometry was used to detect CD64 index,immunofluorescence to detect PCT,and immune scatter turbidity method to detect CRP;the results were analyzed and compared.The receiver operating characteristic curve（ROC curve）was used to analyze the diagnostic values of the three indicators for respiratory tract bacterial infections.Results The CD64 index,PCT and CRP of bacterial infection group were significantly higher than those in control group（P〈0.05）;only the CRP of viral infection group was statistically different from that of control group（P〈0.05）.The positive rates of CD64 index,PCT and CRP in bacterial infection group were higher than those in the control group,reaching 75.0%,72.5% and 55.0% respectively;only the positive rate of CRP in the virus infection group was higher than that in the control group.The area under the curve（AUC）of CD64 index,PCT and CRP was 0.859,0.739 and 0.675respectively;the sensitivity was 90.0%,88.0%and 83.0%respectively;the specificity was 82.0%,78.0% and 74.0%respectively.Conclusion CD64 index,PCT and CRP can be used as the indicators of respiratory tract bacterial infections.The sensitivity and specificity of CD64 are the highest,while those of CRP are the lowest.Combined detection of CD64 index,PCT and CRP can significantly improve the diagnostic sensitivity and specificity of respiratory tract infection diseases,which has great significance in the diagnosis and differential diagnosis of respiratory tract infection diseases.