CD64指数、降钙素原与细胞因子在脓毒症诊疗中的价值  

The therapeutic value of CD64 index and procalcitonin and cytokine levels in the diagnosis and treatment of sepsis

作　　者：张艳[1] 富威[1] 张丽君[1] 王亚柱[1] 颜晓菁[1] 王萍萍[1] ZHANG Yan;FU Wei;ZHANG Lijun;WANG Yazhu;YAN Xiaojing;WANG Pingping(Department of Hematology,The First Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院血液科,沈阳110001

出　　处：《中国医科大学学报》2022年第9期832-835,共4页Journal of China Medical University

摘　　要：目的探讨中性粒细胞CD64指数、降钙素原(PCT)与细胞因子在重症监护病房(ICU)感染患者并发脓毒症的临床诊疗中的价值。方法选取ICU病房85例感染患者,其中脓毒症患者62例,非脓毒症患者23例,分别统计CD64指数、PCT、细胞因子等资料;同期健康者100例作为CD64指数对照组。结果与对照组相比,CD64指数在脓毒症组及非脓毒症组表达均增高,差异有统计学意义(P<0.05);与非脓毒症感染组相比,CD64指数、PCT、C反应蛋白(CRP)、白细胞介素(IL)-6在脓毒症组表达增高,差异有统计学意义(P<0.05);受试者操作特征(ROC)曲线显示,CD64指数、PCT、CRP、IL-6及四者联合诊断脓毒症曲线下面积分别为0.779、0.730、0.737、0.493、0.813;脓毒症组抗感染治疗好转后,CD64指数、PCT、IL-6、IL-10、γ干扰素(INF-γ)水平明显低于治疗前,差异有统计学意义(P<0.05)。结论CD64指数可用于感染性疾病的诊断;诊断脓毒症时,CD64指数优于PCT、CRP及IL-6,但四者联合的诊断价值更佳。监测CD64指数、PCT与细胞因子对脓毒症患者疗效观察具有指导意义。Objective To investigate the clinical diagnosis and therapeutic value of neutrophil CD64 index and levels of procalcitonin(PCT) and cytokines in patients with sepsis who were admitted to the intensive care unit(ICU). Methods Eighty-five infected patients in the ICU were selected. Among them,62 patients were diagnosed with sepsis and 23 were diagnosed without sepsis. The data on CD64index and PCT and cytokine levels were analyzed. The CD64 index was obtained in 100 healthy subjects that served as the control group.Results Compared with that of the control group,the CD64 index increased in both the sepsis and non-sepsis groups,and the differences were statistically significant(P < 0.05). Compared with the non-sepsis infected group,the CD64 index,C-reactive protein and PCT and IL-6 levels all increased in the sepsis group,and the differences were statistically significant(P < 0.05). Based on the receiver operating characteristic curve analysis,the values of the area under the curve of the CD64 index and levels of PCT,C-reactive protein,IL-6,and the combination of the four markers to detect sepsis were 0.779,0.730,0.737,0.493,and 0.813,respectively. After anti-infective treatment,the CD64 index and levels of PCT,IL-6,IL-10,and INF-γ in sepsis patients significantly decreased compared with those during pretreatment,and the differences were statistically significant(P < 0.05). Conclusion The CD64 index can be used in the diagnosis of infectious diseases. For the diagnosis of sepsis,the diagnostic value of CD64 index is higher than that of PCT,CRP,and IL-6,but the combined diagnostic value of the four markers is much higher. Monitoring the CD64 index and levels of PCT and cytokines can serve as a guide in the observation of therapeutic effect in sepsis patients.

关 键 词：脓毒症 CD64指数 降钙素原 C反应蛋白 细胞因子 

分 类 号：R733.7[医药卫生—肿瘤]