sTREM-1和中性粒细胞表面CD64表达在脓毒症早期诊断的价值  

Value of sTREM-1 and CD64 on surface of neutrophil for the early diagnosis of sepsis

作　　者：张羿[1] 易思华[1] 张晓微[2] 金凤玲[1] 

机构地区：[1]兰州大学第一医院检验科,730000 [2]兰州大学第一医院中心实验室,730000

出　　处：《国际检验医学杂志》2012年第13期1590-1592,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨血清可溶性髓系细胞表达触发蛋白-1(sTREM-1)及中性粒细胞表面CD64表达水平对脓毒症的早期诊断价值。方法应用双抗体夹心酶联免疫吸附法(ELISA)测定血清sTREM-1浓度,应用流式细胞技术测定中性粒细胞表面分子CD64的表达,应用受试工作特征ROC曲线研究sTREM-1、CD64的诊断效能。结果脓毒症组、SIRS组与健康对照组血清sTREM-1中位数水平分别为255.34、184.58和128.64pg/mL,三组间比较,差异有统计学意义,P<0.01;脓毒症组CD64阳性百分率中位数为79.96%,高于SIRS组和健康对照组(分别为47.50%、16.37%),三组间比较差异有统计学意义,P<0.05。血清sTREM-1诊断脓毒症ROC曲线下面积为0.75,在临界值取208.86时sTREM-1诊断脓毒症的敏感性74%,特异度70%。CD64阳性百分率以57.83%为界时,诊断脓毒症的敏感度为85%,特异度为75%,ROC曲线下面积为0.77。2项指标联合检测,ROC曲线下面积为0.86,敏感性达90%,特异性为62%。结论外周血sTREM-1、中性粒细胞表面CD64检测对于脓毒症的诊断及鉴别具有一定价值,两者联合检测对早期诊断可能更具意义。Objective To investigate the diagnostic value of serum soluble triggering receptor expressed on myeloid cell-1（sTREM-1） and CD64 expression on the surface of neutrophil in patients with sepsis.Methods sTREM-1 was measured by double-antibody sandwich enzyme-linked immunosorbent assay（ELISA）.CD64 was measured by automatic flow cytometry.The diagnostic value of sTREM-1 and CD64 were assessed by receiver operating characteristic（ROC） curve analysis.Results Median concentrations of Serum sTREM-1 in sepsis,non-infectious SIRS and control groups were 255.34,184.58 and 128.64 pg/mL,respectively.Level of sTREM-1 in patients with sepsis was significantly higher than in patients with non-infectious SIRS and control group（P〈0.01）.Level of peripheral blood neutrophil CD64 in sepsis group（79.96%） was significantly higher than that in the other two groups（47.50% and 16.37%,P〈0.05）.The area under ROC curve of sTREM-1 for the diagnosis of sepsis was 0.75,taking cut-off level of 208.86 pg/mg,with sensitivity of 74% and specificity of 70%.At cut-off level of 57.83%,the sensitivity and specificity of CD64 were 85% and 75% respectively,and the area under ROC curve for the diagnosis of sepsis was 0.77.The area under ROC curve of combination was 0.86.Conclusion Serum sTREM-1 and CD64 detection might have diagnostic value for sepsis.Combined detection might be with better diagnostic value.

关 键 词：脓毒症 可溶性髓系细胞表达触发受体-1 CD64 

分 类 号：R459.7[医药卫生—急诊医学]