nCD64和mCD169在急性感染早期患者中的表达及临床价值  

Expression and clinical value of nCD64 and mCD169 in patients with early acute infection

作　　者：张雅曦 杨倩婷[1] 张明霞[1] 张洁云[1] 余志勇[1] 陈骑[1] ZHANG Yaxi;YANG Qianting;ZHANG Mingxia;ZHANG Jieyun;YU Zhiyong;CHEN Qi(Institute of Hepatology,Shenzhen Third People′s Hospital,Shenzhen,Guangdong 518112,China)

机构地区：[1]深圳市第三人民医院肝病研究所,广东深圳518112

出　　处：《国际检验医学杂志》2023年第20期2453-2456,2461,共5页International Journal of Laboratory Medicine

基　　金：国家自然科学基金面上项目(82172286);深圳市科技计划基础研究面上项目(JCYJ20210324131603008)。

摘　　要：目的评价中性粒细胞CD64(nCD64)和单核细胞CD169(mCD169)在快速鉴别呼吸道病毒感染和细菌感染的价值。方法选取2023年4-7月在该院发热门诊诊断为上呼吸道感染的392例患者作为研究对象,包括287例呼吸道病毒性感染患者(病毒感染组)和105例细菌性上呼吸道感染患者(细菌感染组)。另选取同期无感染的171例健康志愿者作为健康对照组。利用流式细胞术检测各组外周血中淋巴细胞、单核细胞和中性粒细胞的CD64和CD169的平均荧光强度(MFI),并通过各群细胞荧光强度建模计算nCD64指数和mCD169指数。比较3组感染指标的差异,并通过绘制受试者工作特征(ROC)曲线分析评价各指标对呼吸道细菌感染和病毒感染的诊断效能。结果3组受试者nCD64和mCD169、CRP和WBC比较,差异有统计学意义(P<0.05),并且细菌感染组nCD64指数、CRP和WBC较健康对照组明显升高,病毒感染组mCD169指数较健康对照组明显升高,差异均有统计学意义(P<0.001)。ROC曲线分析显示,nCD64指数、CRP和WBC诊断细菌感染的曲线下面积(AUC)为0.918、0.950和0.938,mCD169指数诊断新型冠状病毒感染、甲型流感病毒感染和柯萨奇病毒感染的AUC分别为0.934、0.940和0.974。结论细菌感染指标及mCD169指数均对呼吸道感染疾病有较高的诊断效能,流式细胞术快速检测nCD64指数和mCD169指数对发热就诊分类管理有重要意义。Objective To evaluate the value of neutrophil CD64(nCD64)and monocyte CD169(mCD169)in rapidly differentiating respiratory virus infection from bacterial infection.Methods Totally 392 patients diagnosed with upper respiratory tract infection in fever clinic of our hospital from April to July 2023 were selected as the study objects,including 287 patients with respiratory tract viral infection(viral infection group)and 105 patients with bacterial upper respiratory tract infection(bacterial infection group).Another 171 healthy volunteers without infection were selected as healthy control group.The mean fluorescence intensity(MFI)of CD64 and CD169 of lymphocytes,monocytes and neutrophils in peripheral blood of each group was detected by flow cytometry,and the nCD64 index and mCD169 index were calculated by modeling the fluorescence intensity of each group of cells.The difference of infection indexes among the three groups was compared,and the diagnostic efficiency of each index for acute bacterial and viral infections of respiratory tract was evaluated by drawing receiver operating characteristic(ROC)curve.Results There were statistically significant differences among the three groups on nCD64,mCD169,CRP and WBC(P<0.05).nCD64 index,CRP and WBC in bacterial infection group were significantly higher than those in healthy control group,while mCD169 index and WBC in viral infection group were significantly higher than those in healthy control group,and the differences were statistically significant(P<0.001).ROC curve analysis showed that the area under the curve(AUC)of nCD64 index,CRP and WBC for diagnosing bacterial infection were 0.918,0.950 and 0.938,while the AUC of mCD169 index for diagnosing SARS-CoV-2 infection,influenza A virus infection and Coxsackie virus infection were 0.934,0.940 and 0.974,respectively.Conclusion Both bacterial infection index and mCD169 index have high diagnostic efficacy for respiratory tract infection.Flow cytometry rapid detection of nCD64 index and mCD169 index is of great significance fo

关 键 词：流式细胞术 细菌感染 病毒感染 nCD64 mCD169 

分 类 号：R446.1[医药卫生—诊断学]