CD64指数在慢性阻塞性肺疾病急性加重期患者抗感染治疗中的临床应用  

The clinical applications of CD64 index on the anti-infection treatment in acute exacerbations of chronic obstructive pulmonary disease(AECOPD)patients

作　　者：赵兵[1] 张苗苗[1] 张虹[1] 解晶[1] 

机构地区：[1]浙江省台州市第一人民医院检验科,浙江台州318020

出　　处：《中国现代医生》2015年第36期127-130,F0003,共5页China Modern Doctor

基　　金：浙江省台州市黄岩区科技计划项目[2012038(9)]

摘　　要：目的 探讨中性粒细胞CD64平均荧光强度指数（CD64指数）在慢性阻塞性肺疾病急性加重期（AECOPD）患者抗感染治疗中的临床应用。方法 选取2013年9月-2014年12月在本院呼吸科接受住院治疗的120例慢性阻塞性肺疾病（COPD）患者,其中AECOPD患者81例,COPD稳定期39例;同时选取本院健康体检者33例为对照组。采用流式细胞仪检测CD64指数,同时检测血清降钙素原（PCT）、C-反应蛋白（CRP）、白细胞（WBC）计数及中性粒细胞百分比（NEU%）。结果 AECOPD组CD64指数明显高于COPD稳定期组和健康对照组,差异具有统计学意义（P〈0.05）;同时CD64指数与PCT、CRP、NEU%呈正相关,与WBC计数无相关性;当CD64指数截取值为2.54时,其诊断AECOPD细菌感染的敏感性为86.3%,特异性为90.5%。结论 CD64指数可以作为AECOPD患者细菌感染的早期诊断指标,指导临床用药。Objective To investigate the clinical applications of neutrophils CD64 average mean fluorescence intensity index（CD64 index） on the anti-infection treatment of acute exacerbations of chronic obstructive pulmonary disease（AECOPD） patients.Methods A total of 120 cases of chronic obstructive pulmonary disease（COPD） patients who had received hospital treatment in respiratory department from September 2013 to December 2014 were selected,including81 cases of AECOPD patients and 39 cases of COPD stable phase patients;at the same time,33 cases of healthy volunteers were selected as control group.Flow cytometry was applied to measure the CD64 index,and procalcitonin（PCT）,C-reactive protein（CRP）,white blood cell（WBC） count and neutrophils percentage（NEU%） were measured.Results the CD64 index in AECOPD group was significantly higher than COPD stable phase group and control group,the difference was significant（P〈0.05）;CD64 index was positively correlated with PCT.CRP and NEU%,but was not correlated with WBC count;when the intercept value of CD64 index was 2.54,the sensitivity to diagnose AECOPD bacterial infection was 86.3%with specificity of 90.5%.Conclusion Therefore,CD 64 can be used as an early phase diagnose indicator of bacterial infection of AECOPD patient,and can guide the clinical medicine treatment.

关 键 词：慢性阻塞性肺疾病 CD64 降钙素原 抗感染治疗 

分 类 号：R563[医药卫生—呼吸系统]