中性粒细胞黏附因子CD11b与CD64表达对新生儿感染的早期诊断价值  

Early Diagnosis of Neonatal Infection by Evaluation of Neutrophil Adhesion Molecule CD11b and CD64 Expression

作　　者：郝丽红[1] 麻庆荣[1] 张文双[1] 刘晓军[1] 许俐[1] 郭静[1] 张芳[1] 高海涛[1] 

机构地区：[1]天津市儿童医院新生儿科,300074

出　　处：《天津医药》2011年第4期325-328,共4页Tianjin Medical Journal

基　　金：天津市卫生局科技基金项目(项目编号04KY25)

摘　　要：目的：探讨外周血中性粒细胞黏附因子CD11b、CD64表达在新生儿细菌感染早期诊断及疗效评价中的价值。方法：记录我院新生儿病房住院疑为细菌感染的63例患儿的临床表现、血培养、脑脊液培养结果,检测5项非特异性指标。分为败血症组33例,非败血症感染组30例,另设对照组15例。各组患儿在入院后24-48h内取外周静脉血1mL,采用流式细胞仪检测中性粒细胞CD11b、CD64表达。败血症组在恢复期（治疗1周后）复查。结果：败血症组中性粒细胞CD11b、CD64表达均高于非败血症感染组和对照组（P〈0.05）。败血症组在恢复期CD11b、CD64表达水平下降（P〈0.05）。以CD11b≥320MFI（MFI为平均荧光强度）、CD64≥20MFI为临界值阳性标准,其诊断败血症的敏感度分别为72.73%和75.00%,特异度分别为94.74%和80.49%。CD11b和CD64在革兰阳性菌和阴性菌感染时表达差异无统计学意义。结论：应用流式细胞术测定中性粒细胞黏附因子CD11b、CD64,可作为早期诊断新生儿败血症的实验室依据之一,动态观察其水平变化,对判断感染程度、治疗效果评价具有临床应用价值。Objective： To investigate the value of the peripheral blood neutrophil adhesion molecule CD11b and CD64 expression in the early diagnosis of neonatal bacterial infection, and the efficacy thereof. Methods： Sixty-three neonatal cases with suspected bacterial infection who were hospitalized from May 2005-May 2008 were recruited into the study. The clinical manifestations, blood culture, cerebrospinal fluid culture were collected in neonatal patients. Five non-specific indices were measured for each patient. The neonatal patients were divided into sepsis group （n = 33） and non-septicemic infection group （n = 30）. Fifteen hospitalized neonates with non-infectious diseases were enrolled as controls （n = 15）. The peripheral blood samples of 1mL were taken from patients of each group within 24~48 h of admission. The levels of peripheral blood neutrophil CD11b and CD64 were measured by flow cytometry, which were measured again during the recovery period （after treatment 1 week） for sepsis group. Results： The levels of peripheral blood neutrophil CD11b and CD64 were higher in sepsis group than those of non-septicemic infection group and control group （P 0.05）. The levels of CD11b and CD64 were significantly decreased in the restoration stage of sepsis group （P 0.05）. The positive critical value of sepsis group were CD11b≥320 MFI and CD64≥20 MFI, which showed that diagnostic sensitivity of sepsis were 72.73% and 75.00%, and the specificity were 94.74% and 80.49%. The expressions of neutrophil CD11b and CD64 were no significant significance between gram-positive bacteria and gram-negative bacteria infection. Conclusion： The expression of peripheral blood neutrophil adhesion molecule CD11b and CD64 measured by flow cytometry can be used as one of the laboratory index for early diagnosis of neonatal sepsis. There is clinical value in judging the degree of infection, evaluation of treatment by dynamically observation of their levels.

关 键 词：细菌感染 脓毒症 抗原 CD11b 受体 IgG 中性白细胞 流式细胞术 革兰阳性菌 革兰阴性菌 婴儿 新生 

分 类 号：R725.104[医药卫生—儿科]