外周血CD4^(+)、CD3^(-)CD16^(+)CD56^(+)、CD8^(+)、CD19^(+)联合预测EBV感染相关噬血细胞综合征患者生存结局的价值  

Value of combined prediction of peripheral blood CD4^(+),CD3^(-)CD16^(+)CD56^(+),CD8^(+),CD19^(+)for survival outcome in patients with EBV infection-associated hemophagocytic syndrome

作　　者：彭喆 邢沛 王辰璐 宇文杰 贾宇丽 PENG Zhe;XING Pei;WANG Chenlu;YU Wenjie;JIA Yuli(Department of Clinical Laboratory,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 101400,China;Medical Records and Clinical Data Center,Peking University First Hospital,Beijing 100034,China;Department of Clinical Laboratory,Daxing District Integrated Traditional Chinese and Western Medicine Hospital,Beijing 100076,China;Department of Clinical Laboratory,Beijing Ditan Hospital Affiliated to Capital Medical University,Beijing 101212,China)

机构地区：[1]首都医科大学附属北京友谊医院检验科,北京101400 [2]北京大学第一医院病案与临床数据中心,北京100034 [3]北京市大兴区中西医结合医院检验科,北京100076 [4]首都医科大学附属北京地坛医院检验科,北京101212

出　　处：《国际检验医学杂志》2025年第8期982-986,991,共6页International Journal of Laboratory Medicine

摘　　要：目的分析外周血CD4^(+)、CD3^(-)CD16^(+)CD56^(+)、CD8^(+)、CD19^(+)联合预测EB病毒感染相关噬血细胞综合征(EBV-HLH)患者死亡风险的价值。方法选取2021年5月至2023年4月首都医科大学附属北京友谊医院和北京大学第一医院诊治的84例EBV-HLH患者,根据6个月内生存结局分为死亡组(17例)、生存组(67例)。比较两组一般资料、外周血T淋巴细胞亚群,采用多因素Logistic回归分析EBV-HLH患者死亡的影响因素,采用受试者工作特征(ROC)曲线评估外周血T淋巴细胞亚群对EBV-HLH患者死亡的预测价值。结果死亡组血小板计数、血红蛋白、CD4^(+)、CD3^(-)CD16^(+)CD56^(+)水平均低于生存组(P<0.05),CD8^(+)、CD19^(+)水平高于生存组(P<0.05);多因素Logistic回归分析显示,血小板计数、血红蛋白、CD4^(+)、CD3^(-)CD16^(+)CD56^(+)均为EBV-HLH患者死亡的独立保护因素(P<0.05),CD8^(+)、CD19^(+)则为EBV-HLH患者死亡的独立危险因素(P<0.05);ROC曲线结果显示,CD4^(+)、CD8^(+)、CD19^(+)、CD3^(-)CD16^(+)CD56^(+)联合预测EBV-HLH患者死亡的曲线下面积为0.923,灵敏度、特异度分别为94.12%、80.60%,明显高于各项指标单独预测(P<0.05)。结论EBV-HLH患者外周血CD4^(+)、CD3^(-)CD16^(+)CD56^(+)、CD8^(+)、CD19^(+)异常表达与其生存结局有关,CD4^(+)、CD3^(-)CD16^(+)CD56^(+)、CD8^(+)、CD19^(+)联合预测患者死亡具有较高的参考价值。Objective To analyze the value of combined prediction of peripheral blood CD4^(+),CD3^(-)CD16^(+)CD56^(+),CD8^(+),CD19^(+)for the risk of death in patients with Epstein-Barr virus-associated hemophagocytic syndrome(EBV-HLH).Methods A total of 84 patients with EBV-HLH who were treated in Beijing Friendship Hospital Affiliated to Capital Medical University and Peking University First Hospital from May 2021 to April 2023 were selected and divided into a death group(17 cases)and a survival group(67 cases)according to their survival outcomes within 6 months.The general information and peripheral blood T lymphocyte subsets of the two groups were compared,multivariate Logistic regression analysis was conducted to investigate the influencing factors of death in EBV-HLH patients,and receiver operating characteristic(ROC)curve was used to evaluate the predictive value of peripheral blood T lymphocyte subsets on death in EBV-HLH patients.Results The platelet count,hemoglobin,CD4^(+)and CD3^(-)CD16^(+)CD56^(+)levels in the death group were lower than those in the survival group,while the levels of CD8^(+)and CD19^(+)were higher than those in the survival group(P<0.05).Multivariate Logistic regression analysis showed that platelet count,hemoglobin,CD4^(+),and CD3^(-)CD16^(+)CD56^(+)were all independent protective factors for the death of EBV-HLH patients,while CD8^(+)and CD19^(+)were independent risk factors for the death of EBV-HLH patients(P<0.05).The ROC curve results showed that the area under the curve of combined prediction of CD4^(+),CD8^(+),CD19^(+),CD3^(-)CD16^(+)CD56^(+)for death in EBV-HLH patients was 0.923,with sensitivity and specificity of 94.12%and 80.60%,respectively,which were significantly higher than those predicted by each individual indicator(P<0.05).Conclusion The abnormal expression of CD4^(+),CD3^(-)CD16^(+)CD56^(+),CD8^(+),and CD19^(+)in peripheral blood of EBV-HLH patients is associated with their survival outcomes,and the combined prediction of CD4^(+),CD3^(-)CD16^(+)CD56^(+),CD8^(+),and CD19^(+)ha

关 键 词：EB病毒感染相关噬血细胞综合征 血红蛋白 血小板计数 生存结局 

分 类 号：R446.1[医药卫生—诊断学]