重症肺炎患者外周血CD64指数、NLR及CD14^(+)单核细胞HLA-DR的检测意义分析  

Analysis of the Detection Significance of Peripheral Blood CD64 Index,NLR and CD14^(+)Monocytes HLA-DR in Patients with Severe Pneumonia

作　　者：熊丹 邓琼 陈婷 XIONG Dan;DENG Qiong;CHEN Ting(不详;Department of Laboratory Medicine,First People's Hospital of Fuzhou,Fuzhou 344000,China)

机构地区：[1]抚州市第一人民医院检验科,江西抚州344000

出　　处：《中国医学创新》2024年第21期166-170,共5页Medical Innovation of China

摘　　要：目的:探讨重症肺炎患者外周血CD64指数、中性粒细胞/淋巴细胞比值(NLR)及CD14^(+)单核细胞人类白细胞DR抗原(HLA-DR)的检测意义。方法:收集2022年1月—2024年3月抚州市第一人民医院收治的80例重症肺炎患者的临床资料进行研究。根据28 d内患者预后情况分组,将死亡患者作为死亡组(n=32),存活患者作为存活组(n=48)。比较两组一般资料及CD64指数、NLR、CD14^(+)单核细胞HLA-DR水平,分析CD64指数、NLR、CD14^(+)单核细胞HLA-DR单独及联合预测重症肺炎预后的价值,以及重症肺炎患者病死的危险因素。结果:两组年龄、入院时急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)比较,差异均有统计学意义(P<0.05)。死亡组CD64指数、NLR均高于存活组,CD14^(+)单核细胞HLA-DR水平低于存活组(P<0.05)。受试者操作特征(ROC)曲线结果显示,CD64指数、NLR、CD14^(+)单核细胞HLA-DR单独及联合预测重症肺炎预后不良的曲线下面积(AUC)分别为0.812、0.769、0.728、0.893,均具有一定预测价值(P<0.05)。logistic回归分析显示,CD64指数>9.15、NLR>12.19、CD14^(+)单核细胞HLA-DR≤44.60%、年龄≥65岁、入院时APACHEⅡ≥21.69分是重症肺炎患者病死的独立危险因素(P<0.05)。结论:CD14^(+)单核细胞HLA-DR水平偏低,CD64指数、NLR偏高提示重症肺炎患者预后不佳,三者联合检测可为临床预测重症肺炎患者预后提供参考。Objective:To explore the detection significance of peripheral blood CD64 index,neutrophil/lymphocyte ratio(NLR)and CD14^(+)monocyte human leukocyte antigen DR(HLA-DR)in patients with severe pneumonia.Method:Clinical data of 80 patients with severe pneumonia admitted to First People's Hospital of Fuzhou from January 2022 to March 2024 were collected for study.According to the prognosis of the patients within 28 days,the dead patients were divided into the death group(n=32)and the surviving patients were divided into the survival group(n=48).General data and CD64 index,NLR,CD14^(+)monocyte HLA-DR level were compared between the two groups.The value of CD64 index,NLR,CD14^(+)monocyte HLA-DR alone and combined in predicting the prognosis of severe pneumonia and the risk factors of fatality in patients with severe pneumonia were analyzed.Result:There were significant differences in age,acute physiology and chronic health evaluationⅡ(APACHEⅡ)at admission between the two groups(P<0.05).CD64 index and NLR in death group were higher than those in survival group,and CD14^(+)monocyte HLA-DR level was lower than that in survival group(P<0.05).The results of receiver operating characteristics(ROC)curve showed that the area under the curve(AUC)of CD64 index,NLR and CD14^(+)monocyte HLA-DR alone and combined to predict the prognosis of severe pneumonia were 0.812,0.769,0.728 and 0.893,respectively,all of which had certain predictive value(P<0.05).logistic regression analysis showed that CD64 index>9.15,NLR>12.19,CD14^(+)monocyte HLA-DR≤44.60%,age≥65 years old and APACHEⅡ≥21.69 scores at admission were independent risk factors of fatality in patients with severe pneumonia(P<0.05).Conclusion:Low CD14^(+)monocyte HLA-DR level,high CD64 index and NLR suggest that the prognosis of patients with severe pneumonia is poor,and the combined detection of the three can provide reference for clinical prediction of the prognosis of patients with severe pneumonia.

关 键 词：重症肺炎 CD64 指数 中性粒细胞/ 淋巴细胞比值 CD14^(+) 单核细胞人类白细胞DR 抗原 

分 类 号：R563.1[医药卫生—呼吸系统]