降钙素原、人中性粒细胞载脂蛋白和中性粒细胞CD64检测在细菌性感染早期诊断中的应用

Utility of procalcitonin, human neutrophil lipocalin and neutrophil CD64 in early diagnosis of bacterial infection

目的研究细菌性感染患者血液中的降钙素原(PCT)、人中性粒细胞载脂蛋白(HNL)和中性粒细胞CD64(CD64)的表达水平,为临床细菌性感染早期诊疗提供科学依据。方法选取2013年2月—2017年5月就诊治疗确诊的210例感染患者,另选取80例同期健康体检人员为对照组,感染患者分为细菌组105例、病毒组105例,采用热景公司上转发光免疫分析仪检测PCT和HNL、BD FACS calibur流式细胞仪测定并计算CD64百分比、制定工作曲线选取PCT、HNL及CD64截断值,从而分析比较细菌组、病毒组和对照组的PCT、HNL及CD64表达水平和诊断细菌性感染疾病的特异度和灵敏度。结果细菌组与病毒组、对照组的PCT、HNL、CD64和WBC水平分别比较,差异均具有统计学意义(P<0.05)。病毒组与对照组的CD64、WBC水平比较,差异均具有统计学意义(P<0.05)。病毒组与对照组的PCT和HNL水平差异无统计学意义(P>0.05)。PCT的受试者操作特征(ROC)曲线下的面积(AUC)为0.855,AUC(HNL)为0.930,AUC(CD64)为0.928,AUC(WBC)为0.729。PCT、HNL和CD64诊断细菌感染性疾病的截断值分别为:>?0.79 ng/m L、>87.43 ng/m L、>9.01%。结论细菌感染性疾病导致PCT、HNL和CD64表达水平升高,PCT、HNL和CD64可用于细菌感染性疾病的早期诊断,其中HNL的诊断价值最高。

Objective To examine the expression levels of procalcitonin(PCT), neutrophils apolipoprotein(human neutrophil lipocalin, HNL) and neutrophil CD64(CD64) in the blood of patients with bacterial infection and investigate their utility in early diagnosis and treatment of bacterial infection. Methods A total of 210 patients with confirmed infection who were treated in hospital from February 2013 to May 2017 were enrolled. The patients were classified into bacterial infection group(105 cases) and viral infection group(105 cases). Additionally, a cohort of 80 healthy subjects were randomly selected from health checkup during the same period as the control group. PCT and HNL were determined on the UPT up-converting phosphor microbial immunity analyzer provided by Beijing Hotgen Biotech Company. BD FACS calibur flow cytometer was used to measure and calculate CD64 percentage. Results The levels of PCT, HNL, CD64 and WBC were compared between bacterial infection group, viral infection group and control group. The between-group difference was statistically significant(P<0.05). The CD64 and WBC levels were significantly different between viral infection group and control group(P<0.05), but the PCT and HNL levels were not different significantly between viral infection group and control group(P>0.05). The area under the ROC curve of PCT, namely AUC PCT, was 0.855, and AUC(HNL) was 0.930, AUC(CD64) 0.928, and AUC(WBC) 0.729. The cutoff value of PCT, HNL and CD64 for diagnosis of bacterial infections was >0.79 ng/m L, >87.43 ng/m L, and >9.01%, respectively. Conclusions Bacterial infection is associated with elevated levels of PCT, HNL and CD64, which can be used in early diagnosis of bacterial infections. HNL may provide the highest diagnostic value.