中性粒细胞CD64指数对新生儿吸入性肺炎的诊断价值  

Application value of neutrophil CD64 index in diagnosis of neonatal aspiration pneumonia

作　　者：李娟 石青峰 李春亮 银娜秋 杨益锋 黄超宇 张雪琳 蒋文钦 黄嘉锦 贺际芸 LI Juan;SHI Qingfeng;LI Chunliang;YIN Naqiu;YANG Yifeng;HUANG Chaoyu;ZHANG Xuelin;JIANG Wenqin;HUANG Jiajin;HE Jiyun(Department of Laboratory Medicine,Guilin People′s Hospital,Guilin,Guangxi 541002,China;Department of Neonatology,Guilin People′s Hospital,Guilin,Guangxi 541002,China;Department of Laboratory Medicine,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin,Guangxi 541002,China)

机构地区：[1]广西壮族自治区桂林市人民医院检验科,广西桂林541002 [2]广西壮族自治区桂林市人民医院新生儿科,广西桂林541002 [3]广西壮族自治区南溪山医院检验科,广西桂林541002

出　　处：《检验医学与临床》2024年第9期1214-1217,共4页Laboratory Medicine and Clinic

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210910)。

摘　　要：目的探讨中性粒细胞CD64(nCD64)指数在新生儿吸入性肺炎诊断中的价值。方法选取2021年7月到2022年7月在桂林市人民医院生产过程中吸入胎粪或羊水的105例新生儿为研究对象,根据临床诊断结果分为吸入性肺炎85例(感染组)和未发生吸入性肺炎20例(对照组)。检测两组新生儿的白细胞计数(WBC)、中性粒细胞百分比(N%)、超敏C反应蛋白(hs-CRP)水平,并计算nCD64指数。绘制受试者工作特征(ROC)曲线分析nCD64指数、WBC、N%、hs-CRP对新生儿吸入性肺炎诊断的效能。结果感染组nCD64指数、WBC、N%均高于对照组,差异均有统计学意义(P<0.05);感染组hs-CRP水平高于对照组,但差异无统计学意义(P>0.05)。ROC曲线分析结果显示,nCD64指数单独诊断新生儿吸入性肺炎的曲线下面积(AUC)为0.882(95%CI:0.802~0.961),灵敏度、特异度分别为88.2%、75.0%;N%诊断的AUC为0.672(95%CI:0.537~0.806),灵敏度、特异度分别为83.5%、60.0%;WBC诊断的AUC为0.650(95%CI:0.516~0.783),灵敏度、特异度分别为57.6%、75.0%。结论nCD64指数在新生儿吸入性肺炎感染的诊断中具有较高价值,值得临床推广。Objective To investigate the value of neutrophil CD64(nCD64)index in the diagnosis of neonatal aspiration pneumonia.Methods From July 2021 to July 2022,105 neonates with meconium or amniotic fluid aspiration during delivery in Guilin People′s Hospital were selected for the study,and divided into 85 cases with neonatal aspiration pneumonia infection(infection group)and 20 cases without aspiration pneumonia(control group)according to the clinical diagnosis.The levels of white blood cells(WBC),neutrophil percentage(N%)and hypersensitive C-reactive protein(hs-CRP)were detected in the two groups,and the nCD64 index was calculated.The efficacy of nCD64 index with WBC,N%and hs-CRP for the diagnosis of aspiration pneumonia in neonates was analyzed by plotting receiver operating characteristic(ROC)curve.Results The levels of nCD64 index,WBC and N%in the infection group were higher than those in the control group(P<0.05);the hs-CRP level in the infection group was higher than that in the control group,but the difference had no statistical significance(P>0.05).The results of the ROC curves showed that the area under the curve(AUC)for the diagnosis of aspiration pneumonia in newborn infants by nCD64 index alone was 0.882(95%CI:0.802-0.961),with a sensitivity and specificity of 88.2%and 75.0%,respectively;the AUC of N%for the diagnosis of aspiration pneumonia was 0.672(95%CI:0.537-0.806),with a sensitivity and specificity of 83.5%and 60.0%,respectively;the AUC of WBC for the diagnosis of aspiration pneumonia was 0.650(95%CI:0.516-0.783),with a sensitivity and specificity of 57.6%and 75.0%,respectively.Conclusion The nCD64 index has a high value in the diagnosis of neonatal aspiration pneumonia infection,which is worthy of clinical promotion.

关 键 词：中性粒细胞CD64指数 新生儿吸入性肺炎 白细胞计数 超敏C反应蛋白 诊断 

分 类 号：R725.6[医药卫生—儿科]