CD64和C-反应蛋白在重症肺炎患者中的诊断价值  

Diagnostic utility of CD64 and C-reactive protein in patients with severe pneumonia

作　　者：王斌[1] 张俭[2] 吴晓梁[1] 方强[1] 

机构地区：[1]浙江大学医学院附属第一医院重症医学科,浙江杭州310003 [2]杭州师范大学附属医院重症医学科,浙江杭州310015

出　　处：《中国卫生检验杂志》2016年第19期2816-2818,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨外周血中性粒细胞CD64表达水平在重症肺炎患者早期诊断中的价值。方法收集重症肺炎患者58例、普通肺炎患者50例,另设对照组50例。用流式细胞仪检测受试者外周血中性粒细胞CD64水平。评价CD64诊断重症肺炎的灵敏度、特异度、阳性预测值和阴性预测值。用受试者工作特征ROC曲线分析CD64诊断重症肺炎的价值。结果重症肺炎组和普通肺炎组均显著高于对照组,且重症肺炎组CD64水平明显高于普通肺炎组,差异有统计学意义(P<0.05);细菌性重症肺炎组CD64的表达明显高于非细菌组,差异有统计学意义(P<0.05);中性粒细胞CD64对重症肺炎诊断的敏感度为85.34%,特异度为78.54%,阳性预测值为77.45%,阴性预测值为73.67%;ROC曲线下面积为0.83。结论外周血中性粒细胞CD64测定有助于早期诊断细菌感染性重症肺炎,并判断病情严重程度。Objective To assess the value of peripheral blood neutrophil CD64 level in the early diagnosis of severe pneumonia.Methods 58 cases of severe pneumonia and 50 cases of common pneumonia were recruited into the study; 50 cases of hospitalized patients with non-infectious diseases were enrolled as controls. The level of peripheral blood neutrophil CD64 was measured by flow cytometry. The sensitivity,specificity,positive predictive value and negative predictive value of CD64 were evaluated,and areas under curve（ ROC） was used to assess the value of CD64 in the diagnose of severe pneumonia. Results The level of peripheral blood neutrophil CD64 in severe pneumonia patients were significantly higher than that of common pneumonia group and control group. Furthermore,it was significantly up-regulated in severe pneumonia patients as comparing with that in common pneumonia group,and the difference was statistically significant（ P 〈 0. 05）. Additionally,the CD64 level of severe pneumonia group was significantly higher than non-bacterial infection group,and the difference was statistically significant（ P 〈 0. 05）. Diagnostic sensitivity of neutrophil CD64 in severe pneumonia was 85. 34%,specificity was 78. 54%,positive predictive was 77. 45%,the positive predictive value was 77. 45%,negative predictive value was 73. 67%,and areas under curve was 0. 83. Conclusion The determination of peripheral blood neutrophil CD64 is helpful for the early diagnosis and evaluation of severity of severe pneumonia.

关 键 词：CD64 C-反应蛋白 重症肺炎 细菌性感染 

分 类 号：R563.1[医药卫生—呼吸系统]