CD64指数和CRP测定对早期诊断新生儿败血症的价值对比研究  

Comparison of the diagnosis value of neutrophil CD64 and CRP as a single test for the early detection of neonatal sepsis

作　　者：杨芳[1] 涂芳芳[1] 项文娜[1] 曾绮丹[1] 

机构地区：[1]温州医科大学附属第三医院儿童医院新生儿科,浙江瑞安325200

出　　处：《中国现代医生》2014年第29期24-27,共4页China Modern Doctor

基　　金：浙江省温州市科技计划项目(Y20130262)

摘　　要：目的比较中性粒细胞CD64指数和CRP作为单一的检测试验对新生儿败血症早期诊断的准确性。方法将36例患儿分为确诊败血症组(10例)、临床诊断败血症组(14例)和对照组(12例),对于确诊败血症组和临床诊断败血症组在出现可疑败血症时给予检测CRP、CD64指数、全血细胞计数和血培养。应用流式细胞技术测定中性粒细胞表面分子CD64的表达,应用受试者工作特征曲线研究CRP、CD64的诊断效能。结果和对照组相比,确诊败血症及临床诊断败血症组,CD64明显升高,而CRP没有明显升高。当最佳截断值CD64取3.2 mg/dL,CRP取1.1 mg/dL时,确诊败血症组,CD64和CRP诊断的敏感性分别为92%和11%,特异性为83%和80%,阳性预测值分别为83%和34%,阴性预测值分别为91%和50%。结论在对可疑败血症进行检测时,CD64指数诊断准确性优于CRP,相比CRP来讲,CD64指数作为单一的检测指标用来早期诊断新生儿败血症是可靠的。Objective To compare the diagnostic accuracy between neutrophil CD64 and C-reactive protein （CRP） as a single test for the early detection of neonatal sepsis. Methods A total of 36 patients who were hospitalized in neonatal intensive care unit （NICU） in our hospital were divided into documented sepsis group（n=10）, clinical sepsis group （n=14） and control newborns （n=12）. CRP, neutrophil CD64, complete blood counts and blood culture were detected at the time of the suspected sepsis for the documented or clinical group. CD64 was measured by automatic flow cytometry. The di-agnostic value of CRP and CD64 was assessed by receiver operating characteristic （ROC） curve analysis. Results CD64 was significantly elevated in the groups with documented or clinical sepsis, whereas CRP was not significantly increased compared with controls. For documented sepsis group, CD64 and CRP had a sensitivity of 92% and11%, a specificity of 83% and 80%, a positive predictive value of 83% and 34% and a negative predictive value of 91% and 50%, respectively, with a cutoff value of 3.2 mg/dL for CD64 and 1.1 mg/dL for CRP. Conclusion The diagnostic ac-curacy of CD64 is superior to CRP when measured at the time of suspected sepsis, which implies that CD64 is a more reliable marker for the early identification of neonatal sepsis as a single determination compared with CRP.

关 键 词：中性粒细胞CD64 CRP 新生儿败血症 

分 类 号：R722.13[医药卫生—儿科]