肝硬化合并自发性细菌性腹膜炎患者外周血中性粒细胞CD64表达变化的临床意义研究  

Clinical significance of CD64 expression in peripheral blood of patients with liver cirrhosis complicated with spontaneous bacterial peritonitis

作　　者：朱燕莉[1] 张海 饶德利[1] 

机构地区：[1]鄂东医疗集团黄石市中心医院内镜中心,湖北黄石435000

出　　处：《中国中西医结合消化杂志》2017年第4期289-291,共3页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：湖北省卫生厅2013~2014年度科研项目(No:JX6C-48)

摘　　要：[目的]检测肝硬化合并自发性细菌性腹膜炎(SBP)患者外周血中性粒细胞CD64表达的变化,探讨了其相关的临床意义。[方法]选取2014年1月~2016年5月我院收治的肝硬化腹水患者87例,其中肝硬化腹水无SBP患者45例,肝硬化腹水SBP患者42例。流式细胞术检测外周血中性粒细胞CD64表达。[结果]肝硬化SBP患者外周血中性粒细胞CD64表达为(26.57±4.18)%,显著高于非SBP患者的(11.62±2.37)%(P<0.01)。肝硬化SBP患者与非SBP患者外周血中性粒细胞计数差异无统计学意义,但肝硬化SBP患者腹水中性粒细胞计数显著高于非SBP患者(P<0.01)。肝硬化SBP患者外周血中性粒细胞CD64表达在Child-Pugh评分A、B、C级间差异有统计学意义(P<0.05),治疗无效组显著高于有效组(P<0.01),患者治疗后死亡组显著高于存活组(P<0.01)。外周血中性粒细胞CD64表达检测诊断肝硬化SBP的敏感性为95.2%(40/42),特异性为93.3%(42/45),阳性预测值为93.0%(40/43),阴性预测值为95.5%(42/44)。[结论]肝硬化合并SBP患者外周血中性粒细胞CD64表达显著升高,其有望用于肝硬化合并SBP患者的早期诊断、临床疗效判定以及预后评估。[Objective]To detect the expression of CD64 in peripheral blood neutrophils of patients with cirrhosis and spontaneous bacterial peritonitis（SBP）, and to explore its clinical significance[Methods]Eight- y-seven liver cirrhosis patients with ascites were enrolled in this study. Which included 45 cases of non-SBP and 42 cases of SBP liver cirrhosis patients. The expression of CD64 in peripheral blood neutrophils was detected by flow cytometry. [Results] The CD64 expression was （26.57 ±4.18）0% in SBP liver cirrhosis patients,which was higher than that of（11. 62 ± 2.37） % in non-SBP liver cirrhosis patients（P〈0.01）. No significant difference of peripheral blood neutrophil count between SBP and non-SBP patients（P〉0.05）. The ascites neutrophil count in SBP liver cirrhosis patients was higher than that in non-SBP liver cirrhosis patients（P〈0.01）. There was significant difference of CD64 expression among different Child-Pugh scores （P〈0.05）. The CD64 expression was significantly higher in ineffective treatment group than that in effective group（P〈0.01）,and death group than that in survival group（P〈0.01）. The sensitivity of peripheral blood neutrophil CD64 expression in the diagnosis of cirrhosis SBP was 95.2 % （40/42）, the specificity was 93.3%（42/45）,positive predictive value was 93% （40/43）and negative predictive value was 95.5% （42/44）. EConclusionThe CD64 expression of peripheral blood neutrophil was significantly increased in cirrhosis pa tients with SBP,which is expected to be used for early diagnosis,clinical outcome and prognosis evaluation.

关 键 词：肝硬化 自发性细菌性腹膜炎 外周血中性粒细胞 CD64分子 

分 类 号：R575.2[医药卫生—消化系统]