nCD64指数对儿童社区获得性肺炎病原学诊断的价值  

Value of neutrophil CD64 index in the etiological diagnosis of community-acquired pneumonia in children

作　　者：徐雷[1] 刘晓萌[2] 孙彩虹 张梦雪[1] 曲政海[1] XU Lei;LIU Xiaomeng;SUN Caihong;ZHANG Mengxue;QU Zhenghai(Children’s Medical Center,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院儿童医学中心,山东青岛266003 [2]青岛大学附属医院医院感染管理部 [3]滨州医学院烟台附属医院小儿内科

出　　处：《精准医学杂志》2025年第1期73-76,共4页Journal of Precision Medicine

基　　金：青岛市科技惠民示范引导专项项目(20-4-1-5-nsh)。

摘　　要：目的探讨中性粒细胞CD64(nCD64)指数对儿童社区获得性肺炎(community acquired pneumonia,CAP)病原学诊断的价值。方法选择2018年11月—2019年7月于我院住院的CAP患儿108例,依据病原学检测结果分为细菌组(57例)、病毒组(31例)和支原体组(20例)。收集并比较各组患儿入院24 h内的nCD64指数、全血白细胞(WBC)计数、全血红细胞沉降率(ESR)及全血C反应蛋白(CRP)、血浆D-二聚体(D-D)、血浆降钙素原(PCT)水平等炎症指标;绘制nCD64指数及其他炎症指标诊断细菌性CAP的受试者工作特征(ROC)曲线,并计算曲线下面积(AUC)、截断值以及诊断的灵敏度、特异度及准确度。结果三组患儿nCD64指数及其他炎症指标比较均有显著性差异(F=6.489~74.681,P<0.05);与其他两组相比,细菌性肺炎组患儿的nCD64指数、全血WBC计数、全血ESR、全血CRP水平及血浆D-D、PCT水平均明显升高(t=15.139~58.371,P<0.05)。ROC曲线显示nCD64指数单独诊断细菌性CAP的灵敏度94.7%,特异度92.2%,准确度93.5%。nCD64指数+全血CRP水平+血浆PCT水平联合诊断细菌性CAP的灵敏度为96.5%,特异度为100%,准确度为98.1%。结论nCD64指数诊断儿童细菌性CAP的灵敏度、特异度和准确度较高,在CAP的病原学诊断中具有较高的价值。Objective To investigate the value of neutrophil CD64(nCD64)index in the etiological diagnosis of community acquired pneumonia(CAP)in children.Methods A total of 108 children with CAP who were hospitalized in our hospital from November 2018 to July 2019 were enrolled,and according to etiology detection results,they were divided into bacterial group with 57 children,viral group with 31 children,and mycoplasma group with 20 children.Related inflammatory markers were collected and compared between groups,including nCD64 index,whole blood white blood cell count(WBC),whole blood erythrocyte sedimentation rate(ESR),whole blood C-reactive protein(CRP),plasma D-dimer(D-D),and plasma procalcitonin(PCT)within 24 h after admission.The receiver operating characteristic(ROC)curve was plotted for nCD64 index and other inflammatory mar-kers in the diagnosis of bacterial CAP,and the area under the ROC curve(AUC),cut-off value,and the sensitivity,specificity,and accuracy of diagnosis were calculated.Results There were significant differences in nCD64 index and other inflammatory markers between the three groups(F=6.489-74.681,P<0.05),and compared with the viral group and the mycoplasma group,the bacterial group had significant increases in nCD64 index,whole blood WBC,whole blood ESR,whole blood CRP,plasma D-D,and plasma PCT(t=15.139-58.371,P<0.05).The ROC curve analysis showed that nCD64 index alone had a sensitivity of 94.7%,a specificity of 92.2%,and an accuracy of 93.5%in the diagnosis of bacterial CAP,and the combination of nCD64 index,whole blood CRP,and plasma PCT had a sensitivity of 96.5%,a specificity of 100%,and an accuracy of 98.1%in the diagnosis of bacterial CAP.Conclusion The nCD64 index has relatively high sensitivity,specificity,and accuracy in the diagnosis of bacte-rial CAP in children,and therefore,it has a high value in the etiological diagnosis of CAP.

关 键 词：中性白细胞 社区获得性感染 肺炎 细菌性 灵敏性与特异性 儿童 

分 类 号：R725.631[医药卫生—儿科]