外周血粒细胞CD64指数对系统性红斑狼疮患者病情活动期与细菌感染的鉴别诊断效果  

Effect of peripheral blood neutrophil CD64 index on differential diagnosis of active stage of systemic lupus erythematosus and bacterial infection

作　　者：蒋远文[1] 姚婉玉[1] 唐秀生[1] 唐俊[1] 赵娜[1] 李顺波 蓝艳[1] JIANG Yuan-wen;YAO Wan-yu;TANG Xiu-sheng;TANG Jun;ZHAO Na;LI Shun-bo;LAN Yan(Affiliated Hospital of Youjiang Medical University for Nationalities,Guangxi Zhuang Autonomous Region,Baise,Guangxi 533000,China)

机构地区：[1]右江民族医学院附属医院皮肤性病科,广西百色533000

出　　处：《中华医院感染学杂志》2020年第2期194-197,共4页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180221)。

摘　　要：目的探究外周血中性粒细胞CD64指数对系统性红斑狼疮(SLE)患者病情活动期与细菌感染的诊断效果。方法选取2012年1月-2018年12月于右江民族医学院附属医院皮肤性病科进行诊断并治疗的系统性红斑狼疮患者138例为研究对象,根据确诊结果将患者分为细菌感染组和非细菌感染组,每组患者69例,非细菌感染组患者按照活动指数(DAL)分为活动期患者(n=33)和稳定期患者(n=36),并选取同期于医院进行体检的健康志愿者共42例作为对照组。采集研究对象外周血检测白细胞计数(White blood cell count,WBC)、血沉(erythrocyte sedimentation rate,ESR)和C-反应蛋白(C-reactive protein,CRP)水平。应用流式细胞术检测外周血中性粒细胞(N)、淋巴细胞(L)和单核细胞(M)表面的CD64平均荧光强度,并根据平均荧光强度计算CD64指数。分析CD64指数与WBC、ESR、CRP的相关性。结果细菌感染组的CD64指数均高于非细菌感染组及对照组,差异有统计学意义(P<0.05);细菌感染组的WBC计数、ESR、CRP水平均高于其他组(P<0.05);CD64指数和WBC、ESR、CRP呈正相关,CD64指数随着WBC(r=543)、ESR(r=0.628)、CRP(r=0.686)含量的升高而增大。结论外周血中性粒细胞CD64指数与患者细菌感染及病情活动密切相关,在临床诊断中可将CD64指数作为SLE患者细菌感染及病情活动的诊断指标之一。OBJECTIVE To explore the effect of peripheral blood neutrophil CD64 index on differential diagnosis of active stage of systemic lupus erythematosus and bacterial infection. METHODS A total of 138 patients who were diagnosed with systemic lupus erythematosus and treated in department of dermatology and STD of Affiliated Hospital of Youjiang Medical College for Nationalities from Jan 2012 to Dec 2018 were recruited as the study objects and were divided into the bacterial infection group and the non-bacterial infection group, with 69 cases in each group.The patients of the non-bacterial infection group were divided into the active stage patients with 33 cases and the stable stage patients with 36 cases according to the activity index(DAL).Meanwhile, 42 healthy volunteers who received physical examination were assigned as the control group.The peripheral blood specimens were collected from the study objects so as to detect the levels of white blood cell(WBC),erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP).The average fluorescence intensity of CD64 on the surface of neutrophils(N), lymphocytes(L) and monocytes(M) in peripheral blood was detected by means of flow cytometry, and the CD64 index was calculated based on the average fluorescence intensity.The correlation between the CD64 index and the WBC, ESR and CRP was observed. RESULTS The CD64 index of the bacterial infection group was significantly higher than that of the non-bacterial infection group and the control group(P<0.05).The levels of WBC, ESR and CRP of the bacterial infection group were significantly higher than those of other groups(P<0.05).The CD64 index was positively correlated with WBC, ESR and CRP, and the CD64 index was increased with the elevation of WBC(r=543), ESR(r=0.628) and CRP(r=0.686). CONCLUSION The CD64 index of peripheral blood is closely associated with the bacterial infection and illness condition, and the CD64 index can be used as an index for clinical diagnosis of bacterial infection and illness condition of the SLE pa

关 键 词：外周血中性粒细胞 CD64指数 系统性红斑狼疮 病情活动期 细菌感染 

分 类 号：R593.241[医药卫生—内科学]