中性粒细胞CD64指数在布鲁菌病中的临床应用价值  

Clinical value of neutrophil CD64 index in brucellosis

作　　者：李智伟[1] 王倩 王玲玲[1] 卢佩佩[1] 李书灵 朱晓玉 贾金彤 陈杰[1] 王昌敏[1] LI Zhiwei;WANG Qian;WANG Lingling;LU Peipei;LI Shuling;ZHU Xiaoyu;JIA Jintong;CHEN Jie;WANG Changmin(People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China;Xinjiang Medical University,Urumqi,Xinjing 830054,China;Shihezi University,Shihezi,Xinjiang 832003,China)

机构地区：[1]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001 [2]新疆医科大学,新疆乌鲁木齐830054 [3]石河子大学,新疆石河子832003

出　　处：《国际检验医学杂志》2024年第13期1541-1545,共5页International Journal of Laboratory Medicine

基　　金：新疆维吾尔自治区自然科学基金杰出青年科学基金项目(2022D01E30);新疆维吾尔自治区自然科学基金面上项目(2023D01C83,2023D01C84);新疆维吾尔自治区科技厅“天山英才”培养项目(2022TSYCCX0102);新疆维吾尔自治区科技厅自治区科技支疆项目(2022E02118)。

摘　　要：目的 探讨中性粒细胞CD64(nCD64)指数作为一种新型生物标志物在鉴别诊断急性期、慢性期布鲁菌病中的临床应用价值。方法 纳入2021年2月至2023年7月在新疆维吾尔自治区人民医院确诊的急性期布鲁菌病患者38例,慢性期布鲁菌病患者48例,收集患者外周血并通过流式细胞术进行nCD64指数检测,分析nCD64指数与疾病严重程度的相关性,采用受试者工作特征(ROC)曲线分析nCD64指数鉴别诊断急性期、慢性期布鲁菌病的灵敏度和特异度,同时,以虎红平板凝集试验(RBPT)、试管凝集试验(SAT)作为对照,评价三者临床诊断参考价值。结果 急性期布鲁菌病患者的nCD64指数高于慢性期布鲁菌病患者(U=216.00,P<0.001),且该指数与疾病严重程度呈正相关(r=0.670,P<0.001)。ROC曲线结果显示,nCD64指数用于鉴别诊断急性期、慢性期布鲁菌病的曲线下面积为0.882(95%CI:0.811~0.952,P<0.001),最佳截断值为2.81,其灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为83.3%、81.6%、80.4%、81.9%和82.6%,nCD64指数鉴别诊断的效能明显优于RBPT、SAT两项定性试验。结论 nCD64指数在鉴别诊断急性期、慢性期布鲁菌病中具有良好的灵敏度和特异度,且倾向于反映疾病的严重程度,在鉴别诊断急性期布鲁菌病和慢性期布鲁菌病中具有临床参考价值,对布鲁菌病的早期诊断和治疗效果监测起到重要的作用。Objective To evaluate the clinical value of neutrophil CD64(nCD64)index as a novel biomarker in the differential diagnosis of acute and chronic brucellosis.Methods A total of 38 patients with acute brucellosis and 48 patients with chronic brucellosis diagnosed in the People′s Hospital of Xinjiang Uygur Autonomous Region from February 2021 to July 2023 were included.Peripheral blood of the patients was collected and nCD64 index was detected by flow cytometry,and the correlation between nCD64 index and disease severity was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the sensitivity and the specificity of nCD64 index in differentially diagnosing acute and chronic brucellosis.Meanwhile,Rose-Bengal Plate Test(RBPT)and Standard Tube Agglutination Test(SAT)were used as controls to evaluate the clinical diagnostic value of the three.Results The nCD64 index of acute brucellosis patients was higher than that of chronic brucellosis patients(U=216.00,P<0.001),and the index was positively correlated with the severity of the disease(r=0.670,P<0.001).The ROC curve analysis results showed that the area under the curve of nCD64 index in the differential diagnosis of acute and chronic brucellosis was 0.882(95%CI:0.811-0.952,P<0.001),the cut-off value was 2.81,and sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 83.3%,81.6%,80.4%,81.9%and 82.6%,respectively.The efficacy of nCD64 index in differential diagnosis of nCD64 index was significantly better than those of the qualitative tests of RBPT and SAT.Conclusion nCD64 index has favourable sensitivity and specificity in the differential diagnosis of acute and chronic brucellosis,and tends to reflect the severity of the disease.It has clinical value in the differential diagnosis of acute brucellosis and chronic brucellosis,and plays an important role in the early diagnosis and treatment effect monitoring of brucellosis.

关 键 词：布鲁菌病 中性粒细胞CD64指数 鉴别诊断 

分 类 号：R446.5[医药卫生—诊断学]