单核细胞CD14^+HLA-DR^+检测在肺切除患者术后感染的诊断意义  

Diagnostic Significance of Determination of HLA-DR+ Antigen on CD14^+ Monocyte for Postoperative Infections in Patients with Lung Resections

作　　者：郑雷 张朝峰 

机构地区：[1]舟山医院病理科,316004 [2]舟山医院检验中心,316004

出　　处：《放射免疫学杂志》2013年第4期481-484,共4页Journal of Radioimmanology

摘　　要：目的:探讨CD14+单核细胞人白细胞DR抗原(HLA-DR)表达率、C反应蛋白(CRP)和WBC对肺切除患者术后感染的预测价值。方法:51例肺切除术后患者分为非感染组(26例)、感染组(25例),分别在第1d、4d、7d和第10d用流式细胞仪检测患者血液中的CD14+单核细胞HLA-DR水平以及CRP和WBC值,并与健康对照组(30例)进行比较。应用受试者工作特征(ROC)的曲线下面积分析各指标对术后感染的诊断价值。结果:感染组和无感染组术后第1dCD14+HLA-DR+、CRP和WBC与健康对照组比较,差异有统计学意义(P值均<0.01)。术后第4d、7d和第10d,感染组的CD14+HLA-DR+、WBC和CRP值与无感染组比较,差异均具有统计学意义(tCD14+HLA-DR+值分别为5.60、5.48和4.70,P值<0.01;tWBC值分别为2.26、2.34和2.23,tCRP值分别为2.29、6.00和8.23,P值均<0.05)。ROC曲线分析表明,CD14+HLA-DR+对肺切除术后感染诊断的特异性和敏感性均高于CRP和WBC。结论:肺切除术后并发感染可引起CD14+HLA-DR+、CRP和WBC的变化,CD14+HLA-DR+检测的敏感性和特异性较高,对肺切除后感染的早期诊断更具临床价值。Objective To investigate the significance of the expression rate of HLA-DR antigen on CD14 monocyte（CD14＋ HLA-DR＋）,C-reactive protein（CRP） and WBC counts of prognostic value on the postoperative infections in patients with lung resections.Methods Clinical data of 51 patients with lung resections were analyzed,and the patients were grouped into the infected（n = 25） and non-infected（n = 26）.CD14＋HLA-DR＋,CRP and WBC values were detected 1,4,7 and 10 days after the operation and the results were compared with those taken from the healthy controls（n = 30）.Areas under the receiver operating characteristic（ROC） curves were used to determine the value in predicting postoperative infections.Results CD14＋HLA-DR＋,CRP and WBC values in the infected group and the non-infected group presented significant difference from those in health controls（P 0.01）.CD14＋HLADR＋,WBC and CRP values in the infected group showed obviously different from those of non-infected group 4,7 and 10 days after operation（tCD14 ＋ HLA-DR ＋ = 5.60,5.48 and 4.70,P 0.01;tWBC = 2.26,2.34 and 2.23;tCRP = 2.29,6.00 and 8.23,P 0.05）.ROC curves suggested that CD14＋HLA-DR＋ value expressed more sensitive and higher specificity than CRP and WBC values in the diagnosis of postoperative infections.Conclusion CD14＋HLA-DR＋,CRP and WBC values change in lung resection patients with postoperative infections.Detection of CD14＋HLA-DR＋ provides higher sensitivity and specificity,which can be used in early diagnosis of postoperative infections in particular.

关 键 词：肺切除 HLA-DR抗原 单核细胞 CD14+ 感染 

分 类 号：R655.3[医药卫生—外科学]