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目的探究中性粒细胞表面CD64表达在重症感染早期诊断及预后中的检验价值。方法选取2015年1月~2015年12月我院收治的感染患者112例作为研究对象,根据病原学检验结果分为重症感染组32例、局部感染组53例、非细菌感染组27例,并选取同期健康体检者44名作为对照组,采用流式细胞术对各组受检者的中性粒细胞表面CD64表达情况进行检验,同时检验外周血白细胞(WBC)、中性粒细胞百分比(Neu%)、C反应蛋白(CRP),对比各组受检者的差异情况。结果重症感染组、局部感染组的CD64表达显著高于非细菌感染组、对照组,差异有统计学意义(P<0.05),且随着感染程度加深CD64表达明显升高,差异有统计学意义(P<0.05),但非细菌感染组与对照组相比,差异无统计学意义(P>0.05);当CD64取临界值1时,敏感性为84.1%,显著高于WBC和Neu%,差异有统计学意义(P<0.05),与CRP相比,差异无统计学意义(P>0.05),特异性为91.2%,显著高于WBC、Neu%和CRP,差异均有统计学意义(P<0.05)。结论中性粒细胞表面CD64表达能够客观的反应感染疾病的程度,在细菌感染检验中应用价值较高,可作为细菌性感染危重患者早期诊断和预后评价的一项有效指标。
Objective To investigate the expression of CD64 on neutrophils in the early diagnosis and prognosis of severe infections. Methods From January 2015 to December 2015, 112 cases of infected patients admitted to our hospital were selected as research objects. According to the results of pathogen test, 32 cases were divided into severe infection group, 53 cases of local infection group and 27 cases of non-bacterial infection group. Forty-four healthy subjects were selected as the control group. Flow cytometry was used to examine the expression of CD64 on the neutrophils in each group. At the same time, the percentage of peripheral white blood cells (WBC), neutrophils (Neu %), C-reactive protein (CRP), comparing the differences between subjects in each group. Results The expression of CD64 in severe infection group and local infection group was significantly higher than that in non-bacterial infection group and control group (P <0.05), and the expression of CD64 was significantly increased with the infection level deepening (P <0.05). However, there was no significant difference between non-bacterial infection group and control group (P> 0.05). When CD64 was taken as a cutoff value of 1, the sensitivity was 84.1%, which was significantly higher than that of WBC and Neu% The difference was statistically significant (P <0.05). Compared with CRP, the difference was not statistically significant (P> 0.05), specificity was 91.2%, significantly higher than WBC, Neu% and CRP, the difference was statistically significant P <0.05). Conclusion The expression of CD64 on neutrophils can objectively reflect the degree of infectious diseases and is of high value in bacterial infection test. It can be used as an effective indicator for the early diagnosis and prognosis evaluation of critically ill patients with bacterial infection.