血清核转录因子-κB及CD64诊断细菌性感染疾病的价值  

Value of serum nuclear factor kappa B and CD64 in diagnosing bacterial infectious diseases

作　　者：田宇[1] 马梦影 辛娜[1] 曾佳 高娟[1] TIAN Yu;MA Mengying;XIN Na;ZENG Jia;GAO Juan(Department of Clinical Laboratory,the First Affiliated Hospital of Xi′an Medical University,Xi′an,Shaanxi,710077;Department of Clinical Laboratory,Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi,710000)

机构地区：[1]西安医学院第一附属医院检验科,陕西西安710077 [2]陕西省人民医院检验科,陕西西安710000

出　　处：《实用临床医药杂志》2022年第19期71-75,共5页Journal of Clinical Medicine in Practice

基　　金：陕西省教育厅专项科研计划项目(20JK0893)。

摘　　要：目的探讨血清核转录因子-κB(NF-κB)、中性粒细胞CD64诊断细菌感染性疾病的效能。方法选取124例细菌性感染者作为研究组,选取同期年龄、性别相匹配的78例体检健康者作为对照组。采用酶联免疫吸附法(ELISA)和流式细胞术检测血清NF-κB水平、外周血CD64,并绘制受试者工作特征(ROC)曲线以分析NF-κB、CD64对细菌性感染的诊断效能。将研究组患者又分为重度感染组52例和一般感染组72例,采用单因素分析探讨细菌性感染者发生重度感染的相关因素,采用多因素Logistic回归模型分析导致重度感染的危险因素。结果研究组患者NF-κB、CD64均高于对照组,差异有统计学意义(P<0.01)。NF-κB、CD64单独诊断细菌性感染的最佳临界值分别为42.35 ng/mL、0.41%,ROC曲线的曲线下面积(AUC)分别为0.759、0.796,敏感度分别为86.54%、88.46%,特异度分别为87.50%、88.89%;两者联合诊断时AUC为0.937,敏感度与特异度分别为96.15%、95.83%。单因素分析显示,重度感染组体温≥38℃、降钙素原≥0.08μg/L、超敏C反应蛋白≥26 mg/L、血红蛋白≤120 g/L、NF-κB≥42.35 ng/mL、白细胞≥10×10^(9)、CD64≥0.41%患者比率均高于一般感染组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,NF-κB≥42.35 ng/mL、CD64≥0.41%是重度细菌感染的独立危险因素(P<0.05)。结论细菌性感染患者NF-κB、CD64均升高,二者联合检测可提高细菌性感染的诊断效能,并可反映病情严重程度。Objective To investigate the efficiencies of serum nuclear factor kappa B(NF-κB)and neutrophil CD64 in the diagnosing bacterial infectious diseases.Methods A total of 124 patients with bacterial infection were selected as research group,and 78 healthy patients with matched age and gender in the same period were selected as control group.Enzyme-linked immunosorbent assay(ELISA)and flow cytometry were used to detect the serum NF-κB level and CD64 in the peripheral blood,and receiver operating characteristic(ROC)curve was drawn to analyze the efficiencies of NF-κB and CD64 in diagnosing bacterial infection.Patients in the research group were further divided into severe infection group with 52 cases and general infection group with 72 cases,univariate analysis was used to explore the related factors affecting the occurrence of severe infection in patients with bacterial infection,and multivariate Logistic regression model was used to analyze the risk factors causing severe infection.Results NF-κB and CD64 in the research group were significantly higher than those in the control group(P<0.01).The optimal cut-off value of NF-κB and CD64 for diagnosing bacterial infection alone was 42.35 ng/mL and 0.41%respectively,the area under the curve(AUC)of ROC curve was 0.759 and 0.796 respectively,the sensitivity was 86.54%and 88.46%respectively,and the specificity was 87.50%and 88.89%respectively;when the NF-κB was combined with CD64for diagnosis,the AUC was 0.937,and the sensitivity and specificity were 96.15%and 95.83%respectively.Univariate analysis showed that the ratios of patients with body temperature≥38℃,procalcitonin≥0.08μg/L,high sensitivity C reactive protein≥26 mg/L,hemoglobin≤120 g/L,NF-κB≥42.35 ng/mL,white blood cell(WBC)≥10×10^(9)and CD64≥0.41%in the severe infection group were significantly higher than those in the general infection group(P<0.05).Multivariate Logistic regression analysis showed that NF-κB≥42.35 ng/mL and CD64≥0.41%were the independent risk factors for severe bacteri

关 键 词：核转录因子-KB 中性粒细胞 细菌性感染疾病 诊断效能 受试者工作特征曲线 

分 类 号：R446.11[医药卫生—诊断学] R378[医药卫生—临床医学]