探讨血清CD64指数在支气管哮喘急性发作抗感染治疗的临床价值

Exploration of the clinical value of serum CD64 index in the anti-infection treatment of acute bronchial asthma

目的探讨血清CD64和CRP水平在支气管哮喘急性发作期抗感染治疗的临床价值。方法收集2014年6月—2017年12月本院入院就诊的支气管哮喘急性发作期患者74例(急性发作组)、慢性持续期患者74例(慢性持续组)以及临床缓解期患者73例(缓解组)作为研究对象。各组均统一在清晨空腹抽取静脉血,分别查血常规、CRP、PCT,使用流式细胞仪检测血清CD64平均荧光强度(MFI);换算成CD64指数,筛选出各组间有差异的指标。进行曲线下面积、Cut off值、灵敏度及特异度的比较。结果与慢性持续组相比,哮喘急性发作期患者CD64指数及CRP升高,差异具有统计学意义(P<0.01),而慢性持续组与缓解组差异无统计学意义(P>0.05),以CD64指数>1.93为临界值,其诊断支气管哮喘敏感度及特异性分别为96.1%和97.4%。CRP以32.41为临界值,其敏感度及特异性分别为78.6%和79.62%。结论血清CD64指数和CRP升高可作为早期诊断支气管哮喘急性发作合并细菌感染的实验依据,对指导抗生素应用有重要价值,动态监测其水平,对评价治疗疗效有一定意义。

Objective To discuss the clinical significance of serum CD64 and CRP level in guiding anti-infection therapy of bronchial asthma acute attack.Methods 74 cases of patients suffered bronchial asthma acute attack(acute attack group),74 cases of patients chronic sustaining bronchial asthma(chronic sustaining group),and 73 cases of clinical alleviate bronchial asthma(clinical alleviate group)admitted to the affiliated hospital of Jiujiang university from June,2014 to December 2017 were enrolled this study.Fasting venous blood was drawn from each group in the morning.The samples were collected for detecting hemocytology,C-reactive protein,procalcitonin and mean fluorescence intensity(MFI)of CD64 in serum by fluid cytology,CD64 MFI were converted into CD64 by conversion formula.To screen the significant indicators for the diagnosis bronchial asthma and to calculate the area under the curve(AUC),cut off value,sensitivity and specificity.Results Compared with the chronic sustaining group,CD64 index and CRP levels of the acute attack group increased,and there were statistical differences between the two groups(P<0.01).The difference between chronic sustaining group and the clinical alleviate group was not statistically significant(P>0.05).Set 1.93 as the cut off value of CD64 index over,the sensitivity and specificity of CD64 index in diagnosis of bronchial asthma were 96.1%and 97.4%respectively.Set 32.41 as cut off value of CRP,the sensitivity and specificity of CRP were 78.6%and 79.62%respectively.Conclusions The increase of CD64 index and serum CRP could be used as the experimental basis of early diagnosing bronchial asthma acute attack combined bacterial infection,which has important value in guiding antibiotics application.Dynamic monitoring the level of them is of some significance in evaluating the efficacy of the treatment.