CD64指数、NEU%、NLR比值及PCT对2型糖尿病酮症酸中毒合并细菌感染的预测价值  

Predictive value of CD64 index, NEU%, NLR and PCT in type 2 diabetic ketoacidosis patients complicated with bacterial infection

作　　者：赵富利 康艳丽[1] 赵迪[2] 马瑜瑾[3] 梁丽君[1] ZHAO Fu-li;KANG Yan-li;ZHAO Di;MAYu-jin;LIANG Li-jun(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China;不详)

机构地区：[1]河南科技大学第一附属医院全科医学科,河南洛阳471000 [2]郑州大学第一附属医院内分泌科,河南郑州450000 [3]河南科技大学第一附属医院内分泌科,河南洛阳471000

出　　处：《中华医院感染学杂志》2022年第16期2439-2443,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81700729)。

摘　　要：目的 探究外周血CD64平均荧光强度指数(CD64指数)、中性粒细胞百分比(NEU%)、中性粒细胞计数/淋巴细胞计数比值(NLR比值)及降钙素原(PCT)水平对2型糖尿病酮症酸中毒(DKA)患者合并细菌感染的预测价值。方法 选择2019年1月-2021年1月来河南科技大学第一附属医院就诊的2型糖尿病DKA患者110例,根据是否合并细菌感染,分为感染组(n=52)和未感染组(n=58)。患者入院后,收集其一般资料、生化指标、外周血CD64指数、NEU%、NLR比值及PCT水平,分析感染组患者病原菌分布。根据患者感染程度,分为轻度感染组(n=29)及重度感染组(n=23),探究四项指标与患者感染程度相关性。结果 DKA合并细菌感染组患者最常见细菌类型为金黄色葡萄球菌,占19.23%,其次为大肠埃希菌,占17.31%;DKA合并细菌感染组外周血CD64指数、NEU%、NLR比值及PCT水平均高于未感染组(P<0.05);重度感染组患者的四项指标水平均高于轻度感染组(P<0.05),且四项指标水平与患者感染程度均呈正相关(P<0.05);ROC曲线分析显示四项指标联合检测预测DKA合并细菌感染的AUC值高于单一CD64指数、NEU%、NLR比值及PCT检测。结论 外周血CD64指数、NEU%、NLR比值及PCT水平对早期DKA合并细菌感染具有一定预测作用,且四项指标联合检测预测价值最高。OBJECTIVE To explore the predictive value of peripheral blood CD64 mean fluorescence intensity index(CD64 index), neutrophil percentage(NEU%), neutrophil to lymphocyte ratio(NLR ratio) and procalcitonin(PCT) in type 2 diabetic ketoacidosis(DKA) patients complicated with bacterial infection. METHODS A total of 110 patients with type 2 DKA treated in the First Affiliated Hospital of Henan University of Science and Technology between Jan 2019 and Jan 2021 were enrolled. They were divided into the infection group(n=52) and non-infection group(n=58) according to whether bacterial infection occurred. After admission, general data, biochemical indexes, peripheral blood CD64 index, NEU%, NLR and PCT level were collected to analyze the distribution of pathogens in the infection group. According to the severity of infection, they were divided into the mild infection group(n=29) and severe infection group(n=23). The correlation between the above four indexes and infection severity was explored. RESULTS The most common type of pathogens in the infection group was Staphylococcus aureus(19.23%), followed by Escherichia coli(17.31%). The peripheral blood CD64 index, NEU%, NLR and PCT levels in the infection group were significantly higher than those in the non-infection group(P<0.05);the four indexes in the severe infection group were significantly higher than those in the mild infection group(P<0.05), and the above indexes were positively correlated with the severity of infection(P<0.05). ROC curves analysis showed that AUC of CD64 index combined with NEU%, NLR and PCT level for predicting bacterial infection was larger than those of the indexes individual. CONCLUSION Peripheral blood CD64 index, NEU%, NLR and PCT level are of certain predictive value in early DKA combined with bacterial infection. The predictive value of their combination is the highest.

关 键 词：糖尿病酮症酸中毒 细菌感染 CD64平均荧光强度指数 中性粒细胞百分比 中性粒细胞计数/淋巴细胞计数比值 降钙素原 

分 类 号：R587.1[医药卫生—内分泌]