CD64及Th1/Th2细胞因子对SAP继发细菌感染的诊断价值  

The diagnostic value of CD64 and Th1/Th2 cytokines in SAP secondary bacterial infection

作　　者：张子弋 王洪建[1] ZHANG Ziyi;WANG Hongjian(Institute of Hematology,The People's Hospital of Puyang,Puyang,Henan,457000,China)

机构地区：[1]濮阳市人民医院血液病研究所,河南濮阳457000

出　　处：《新疆医学》2025年第1期56-59,共4页Xinjiang Medical Journal

摘　　要：目的 探究CD64感染指数及Th1/Th2细胞因子对重症急性胰腺炎(SAP)继发细菌感染的诊断价值。方法 选取2022年1月至2023年11月我院收治的89例SAP患者。根据有无继发细菌感染划分为感染组(36例)、非感染组(53例)。比较两组CD64感染指数、Th1/Th2细胞因子[肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)、白介素-6(IL-6)]水平;Logistic回归分析继发细菌感染的因素;ROC曲线评估CD64与Th1/Th2细胞因子的诊断价值。结果 感染组CD64感染指数、TNF-α、IFN-γ、IL-6较非感染组水平更高(P<0.05)。CD64感染指数(OR=4.188,95%CI=1.932~9.077)、TNF-α(OR=1.108,95%CI=1.045~1.175)、IFN-γ(OR=1.082,95%CI=1.011~1.159)、IL-6(OR=1.074,95%CI=1.004~1.150)是SAP患者继发细菌感染的危险因素(均P<0.05)。CD64感染指数、TNF-α、IFN-γ、IL-6诊断SAP继发细菌感染的AUC分别为0.802、0.737、0.737、0.714;敏感度分别为75.0%、77.8%、75.0%、66.7%,特异度分别为83.0%、66.0%、71.7%、73.6%;而四项联合的诊断效能最好(AUC=0.938,敏感度91.7%,特异度92.5%)。结论 CD64感染指数及Th1/Th2细胞因子TNF-α、IFN-γ、IL-6对SAP继发细菌感染具有诊断价值,且四项联合诊断价值较高。Objective To explore the diagnostic value of CD64 infection index and Th1/Th2 cytokines for secondary bacterial infection in severe acute pancreatitis(SAP).Methods A total of 89 SAP patients admitted to our hospital from January 2022 to November2023 were selected.According to the presence or absence of secondary bacterial infection,the patients were divided into infection group(36 cases)and non-infection group(53 cases).The CD64 infection index,Th1/Th2 cytokines[tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-6(IL-6)]levels were compared between the two groups.Logistic regression was used to analyze the risk factors of secondary bacterial infection.ROC curve was used to evaluate the diagnostic value of CD64 and Th1/Th2 cytokines.Results The levels of CD64 infection index,TNF-α,IFN-γand IL-6 in the infected group were higher than those in the non-infected group(P<0.05).CD64 infection index(OR=4.188,95%CI=1.932-9.077),TNF-α(OR=1.108,95%CI=1.045-1.175),IFN-γ(OR=1.082,95%CI=1.011~1.159)and IL-6(OR=1.074,95%CI=1.004-1.150)were risk factors for secondary bacterial infection in SAP patients(all P<0.05).The AUC of CD64 infection index,TNF-α,IFN-γand IL-6 in the diagnosis of SAP secondary bacterial infection were 0.802,0.737,0.737 and 0.714,respectively;The sensitivity was 75.0%,77.8%,75.0%and 66.7%,and the specificity was 83.0%,66.0%,71.7%and 73.6%,respectively.The combination of the four factors had the best diagnostic efficacy(AUC=0.938,sensitivity91.7%,specificity 92.5%).Conclusion CD64 infection index and Th1/Th2 cytokines TNF-α,IFN-γ,IL-6 have diagnostic value for SAP secondary bacterial infection,and the combination of the four has higher diagnostic value.

关 键 词：重症急性胰腺炎 细菌感染 CD64感染指数 TH1/TH2细胞因子 诊断价值 

分 类 号：R446.11[医药卫生—诊断学]