巨细胞病毒性肺炎儿童体内中性粒细胞表面黏附分子CD11b表达及临床意义

Expression and significance of neutrophil surface adhesion molecules CD11b from cytomegalovirus infection in children

目的探讨感染巨细胞病毒(CMV)感染性肺炎的儿童体内中性粒细胞表面黏附分子CD11b的表达及诊断价值。方法收集2014年11月至2016年10月在我院收治的CMV感染性肺炎儿童113例,年龄2~4岁,其中男80例,女33例,通过CMV-pp65抗原检测将CMV肺炎的儿童分为CMV肺炎高活动性感染组、CMV肺炎活动性感染组和非CMV肺炎感染阴性对照组,同时选取我院门诊体检健康同年龄段儿童男21例、女12例作为健康对照组。采用流式细胞仪分别检测上述各组的中性粒细胞表面黏附分子CD11b表达比例。计算CD11b在诊断儿童CMV肺炎过程中的受试者工作曲线(ROC曲线)。结果 CMV肺炎高活动性感染的儿童中性粒细胞表达CD11b的比例与非CMV肺炎感染阴性对照组和健康对照组比较差异有统计学意义(P<0.05)。CD11b诊断儿童CMV肺炎高活动性感染组的最佳临界值为表达率40.11%,敏感度为100%,特异度为63.19%,受试者工作曲线下面积为0.612;CD11b诊断儿童CMV肺炎活动性感染组的最佳临界值为表达率63.87%,敏感度为92.87%,特异度为98.34%,受试者工作曲线下面积为0.991。结论儿童CMV肺炎感染后中性粒细胞CD11b表达下调,可以作为鉴别诊断儿童CMV肺炎活动性感染的实验室依据。

Objective To study diagnosis and clinical significance of neutrophil surface adhesion molecules including CD11 bfrom cytomegalovirus（CMV）infection pneumonia in children.Methods Blood samples were collected from 113 children of CMV infection pneumonia including male 80 and female 40 cases between November2014 and October 2016.Healthy male 21 cases and female 12 cases served as healthy control group from outpatients in the same period.Children of CMV infection pneumonia were divided into high active CMV infection group,CMV infection group and the negative control group,and healthy group as normal control group according to CMV-pp65 antigen detection.Neutrophil surface adhesion molecule CD11 b was analyzed by flow cytometry and compared respectively.ROC curve of CD11 bin children of CMV infection pneumonia was made.Results The expression ratio of CD11 bin high active CMV infection group was significantly different as compared with negative control group and control group（P〈0.05）;optimal cut-off value of CD11 bin high active CMV infection group was 40.11%,the sensitivity was 100%,the specificity in high active CMV infection group was 63.19%,and the area under the ROC was0.612.The optimal cut-off value of CD11 bin CMV infection group was 63.87%,the sensitivity of CD11 b was92.87%,the specificity of CD11 bwas 98.34%,and the area under of ROC of CD11 b was 0.991.Conclusion The neutrophils CD11 bexpression in children of CMV infection pneumonia is down regulation.CD11 bexpression can be used as a laboratory diagnosis basis of children＇s CMV infection.