外周血中性粒细胞CD_(64)与C反应蛋白诊断烧伤感染的临床价值  

Clinical Value of Neutrophil CD_(64) and C-reactive Protein in Peripheral Blood in Diagnosis of Burns Infection

作　　者：任忠亮 薛佳杰 郭雷[1] 郑朝[2] 王耀军[1] 

机构地区：[1]榆林市第二医院烧伤整形手足外科,陕西榆林719000 [2]解放军第四军医大学附属西京医院烧伤科,西安710000

出　　处：《临床误诊误治》2017年第5期78-81,共4页Clinical Misdiagnosis & Mistherapy

基　　金：国家自然科学基金资助项目(81401593)

摘　　要：目的探讨外周血中性粒细胞CD_(64)与C反应蛋白(CRP)诊断烧伤感染的临床价值。方法将2015年12月—2016年6月榆林市第二医院烧伤整形手足外科收治的烧伤120例根据入院时病情分为烧伤脓毒症组、烧伤局部感染组和烧伤不伴感染组各40例,检测比较各组治疗前外周血中性粒细胞CD_(64)和CRP水平,并比较烧伤脓毒症组治疗前和治疗1周后外周血中性粒细胞CD_(64)与CRP水平,并应用受试者工作特征(receiver operating characteristic,ROC)曲线分析灵敏度及特异度。结果 3组治疗前外周血中性粒细胞CD_(64)和CRP水平总体比较差异均有统计学意义(P<0.05)。治疗前烧伤脓毒症组外周血中性粒细胞CD_(64)和CRP水平明显高于烧伤局部感染组及烧伤不伴感染组,烧伤局部感染组外周血中性粒细胞CD_(64)和CRP水平明显高于烧伤不伴感染组,差异均有统计学意义(P<0.05)。烧伤脓毒症组治疗1周后外周血中性粒细胞CD_(64)及CRP水平较治疗前明显下降,差异均有统计学意义(P<0.05)。ROC曲线下面积比较:Y(0.943)>CRP(0.910)>中性粒细胞CD_(64)(0.926),灵敏度与特异度新变量Y优于外周血中性粒细胞CD_(64)和CRP。结论临床可通过外周血中性粒细胞CD_(64)和CRP水平检测来确定烧伤患者感染程度,外周血中性粒细胞CD_(64)和CRP水平可以为烧伤感染严重程度诊断及治疗结果评价提供参考。Objective To investigate clinical value of neutrophil CD64 and C-reactive protein （CRP） in peripheral blood in diagnosis of burn infection. Methods A total of 120 burns patients admitted during December 2015 and June 2016 were selected and divided into burns sepsis group, burns local infection group and burns without infection group （n = 40 for each group）. Levels of neutrophil CD64 and CRP in peripheral blood before treatment were detected in three groups; levels of neutrophil CD64 and CRP in peripheral blood were compared before and 1 week after surgery in burn sepsis group; receiver op- erating characteristic （ROC） was used to analyze the sensitivity and specificity. Results The differences of neutrophil CD64 and CRP levels in peripheral blood were statistically significant in three groups （P 〈 0.05）. Neutrophil CD64 and CRP levels in peripheral blood in burn sepsis group were significantly higher than those in burn local infection and burn without infection groups, while the levels in burn local infection group were significantly higher than those in burn without infection group （P 〈 0.05 ）. After treatment for 1 week, neutrophil CD64 and CRP levels in peripheral blood were significantly decreased than those before surgery in burn sepsis group （ P 〈 0.05 ）. Receiver operating characteristic （ROC） curve area comparison showed Y （0. 943） 〉 CRP（0. 910） 〉 CDs4 （0. 926） ; new variables Y of sensitivity and specificity was better than neutrophil CD64 and CRP in peripheral blood. Conclusion Infection degree of burns patients can be detected by neutrophil CD64 and CRP levels in peripheral blood in clinic, and the levels can provide reference for evaluating the diagnosing and treating for burns infection.

关 键 词：烧伤 中性粒细胞CD64 C反应蛋白 

分 类 号：R644[医药卫生—外科学]