C反应蛋白、降钙素原、中性粒细胞表面CD35和CD64诊断脓毒症的临床价值  

Study on the clinical significance of CRP,PCT,CD35 and CD64 in diagnosis of sepsis

作　　者：王宾[1] 王红[1] 

机构地区：[1]首都医科大学附属北京友谊医院感染内科,北京100050

出　　处：《临床和实验医学杂志》2017年第8期752-755,共4页Journal of Clinical and Experimental Medicine

基　　金：北京中医药科技发展资金资助项目(编号:JJ2016-12)

摘　　要：目的比较C反应蛋白、降钙素原、中性粒细胞表面CD35和CD64诊断脓毒症的临床价值。方法选取2015年2月到2015年9月于首都医科大学附属北京友谊医院内科住院患者中脓毒症、非感染性全身炎症反应(SIRS)患者及同期随机选择体检中心体检者。抽取患者入院第一天血作为标本,通过流式细胞术测定中性粒细胞表面CD35和CD64;散射比浊法测定C反应蛋白(CRP);免疫色谱检测法测定血清中的降钙素原(PCT)浓度。利用SPSS 22.0统计软件对上述资料进行单因素和多因素分析。结果共入组61例研究对象,其中健康对照组17例,SIRS组15例和脓毒症组29例,CRP、PCT和CD35在SIRS组和脓毒症组差异未达到统计学意义(P=0.193,0.921和0.198);而CD64在SIRS组和脓毒症组差异达到统计学意义(P=0.000);ROC曲线显示CRP、PCT、CD35和CD64曲线下面积分别为0.601,0.509,0.620和0.901。根据ROC曲线计算的CD64区别全身炎症反应综合征(SIRS)组与脓毒症组的诊断界值为130MFI,敏感度为75.9%,特异度93.3%。结论相比于CRP、PCT和CD35,CD64能很好地区分SIRS患者和脓毒症患者。Objective To compare the significance of C - reactive protein （ CRP）, procalcitonin （ PCT）, circulating neutrophil CD35 and CD64 in diagnsosis of patients with sepsis. Methods Patients with sepsis or non - infectious SIRS admitted in this hospial and volunteers from the physical examination center during February 2015 to September 2015 were selected for this study. Blood samples were taken on the first day of admission. The CD35 and CD64 of neutrophils were determined by flow cytometry. CRP was determined by nephelometry and the serum lev-el of PCT was determined by the method of immuno - chromatographic analysis. Monovariate and multivariate analysis had been used to analyze the data by software SPSS 22. 0. Results A total of 61 participants were enrolled, including 17 persons in healthy control group, 15 patients in SIRS group and 29 patients in sepsis group. The levels of CRP, PCT and CD35 were not significantly different between SIRS group and sepsis group （ P=0.193, 0.921 and0.198）. But levels of CD64 showed significant difference （ P=0.000） . The areas under ROC curve of CRP, PCT, CD35 and CD64 were 0.601 ,0. 509 ,0.620 and 0. 901 respectively. According to the ROC curve of CD64 , the diagnostic value for differen-tiation of SIRS and sepsis was 130MFI. Its sensitivity was 75.9% and its specificity was 93. 3% . Conclusion In comparison with CRP, PCT and CD35 , CD64 is a good marker for distinction between SIRS patients and septic patients.

关 键 词：脓毒症 全身炎症反应综合征 C反应蛋白 降钙素原 CD35 CD64 

分 类 号：R459.7[医药卫生—急诊医学]