中性粒细胞CD64与甲状腺激素水平在重症胆道感染患者中的变化和意义  

The change and significance of neutrophil CD64 and thyroid hormone level in bfliary tract infection

作　　者：李媛莉[1] 赵继波[2] 李福龙[2] 黄树伟[1] 李树铁[1] 汪业铭[2] 滕金亮[2] Li Yuan-li;Zhao Ji-bo;Li Fu-long;Huang Shu-wei;Li Shu-tie;Wang Ye-ming;Teng Jin-liang(First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院重症医学科,河北张家口075000 [2]河北北方学院附属第一医院麻醉科,河北张家口075000

出　　处：《中国急救医学》2018年第11期982-985,共4页Chinese Journal of Critical Care Medicine

基　　金：张家口市科技攻关项目（1421145D）

摘　　要：目的 探讨中性粒细胞CD64与甲状腺激素水平在重症胆道感染中的变化和意义。 方法 选择2015-01~2017-12于河北北方学院附属第一医院ICU就诊的重症胆道感染患者300例及同期进行体检的健康人40例（健康组）。根据是否手术和保守治疗，将重症胆道感染患者分为手术组和非手术组，采用流式细胞术检测患者入院时、入院后1 d、5 d、14 d时外周血中中性粒细胞CD64指数，生化检测患者外周血中甲状腺激素相关碘甲状腺原氨酸（T3）、甲状腺素（T4）、三碘甲状腺原氨酸（rT3），以及促甲状腺激素（TSH）的表达水平。 结果 重症胆道感染的患者外周血中中性粒细胞CD64指数（28.65±3.25）明显高于健康组（10.36±2.13），随着时间延长，CD64指数明显下调，与健康组比较差异有统计学意义（P〈0.05）。重症胆道感染患者外周血中T3水平为（0.58±0.11）nmol/L、rT3水平为（0.50±0.18）nmol/L、T4水平为（42.33±5.98）nmol/L、TSH水平为（0.72±0.12）nU/L，均明显低于健康组的T3（1.63±0.52）nmol/L、rT3（1.85±0.85） nmol/L、T4（108.65±12.33）nmol/L、TSH（3.22±0.92）nU/L；随着时间的延长，T3、T4、rT3、TSH的表达水平明显升高。Cox回归结果分析显示，CD64指数、T3、rT3、T4、TSH与重症胆道感染的预后明显相关（P=0.006、0.003、0.003、0.000、0.001）。 结论 重症胆道感染患者外周血中中性粒细胞CD64及甲状腺激素水平与感染预后密切相关，可以作为重症胆道感染的独立预后指标。Objective To investigate the change and significance of neutrophil CD64 and thyroid hormone level in biliary tract infection. Methods A total of 300 patients with biliary tract infection and 40 healthy people who received physical examination in our hospital from January 2015 to December -2017 were selected. According to whether operation, biliary infection patients were divided into operation group and non - operation group. The CD64 index of neutrophils in peripheral blood was detected by flow cytometry, and the levels of thyroid hormone related iodide （T3）, thyroxine （T4）, three iodide adenosine rT3 and thyroid gonadotropin （TSH） in peripheral blood were detected by biochemical assay at the time of admission, 1st day, 5th day and 14th day after admission. Results The CD64 index of neutrophils in peripheral blood of patients with biliary tract infection （28.65 ± 3.25 ） was significantly higher than that of normal people （10.36 ± 2.13 ）. With the prolonged time, the CD64 index decreased significantly, and there was a significant difference compared with those of the healthypeople （P〈0.05）. The expression level ofT3 （0.58±0.11） nmol/L, T3 （0.50 ±0.18） nmol/L, T4 （42.33 ±5.98） nmol/L, TSH （0.72 ±0.12） nU/L in peripheral blood of patients with biliary tract infection was significantly lower than that of healthy people T3 （ 1.63 ± 0.52） nmol/L, T3 （ 1.85 ± 0.85） nmol/L, T4 （108. 65± 12. 33） nmol/L, TSH （3. 22 ±0. 92） nU/L （P 〈0. 05）. The expression level of T3, T4, rT3 and TSH increased significantly with the prolongation of time. Cox regression analysis showed that the CD64 index and thyroid hormone level of neutral cells were closely related to the prognosis of biliary tract infection （ P = 0. 006, 0. 003, 0. 003, 0. 000, 0. 001 ）. Conclusion The level of neutrophils CD64 and thyroxine in peripheral blood of patients with biliary tract infection is closely related to the prognosis of infection, which can be used as an independent prognos

关 键 词：重症胆道感染 中性粒细胞 甲状腺激素水平 

分 类 号：R593.241[医药卫生—内科学]