实用医学杂志 ›› 2021, Vol. 37 ›› Issue (11): 1418-1427.doi: 10.3969/j.issn.1006⁃5725.2021.11.009

• 临床研究 • 上一篇    下一篇

改良中性粒细胞CD64指数鉴别诊断感染的临床应用效能

高雪丹, 蔡宜含, 冯伟华, 李壹, 罗俐梅, 王兰兰, 蔡蓓    

  1. 四川大学华西医院实验医学科(成都 610041)

  • 出版日期:2021-06-10 发布日期:2021-06-10
  • 通讯作者: 蔡蓓 E⁃mail:evacaiayou@126.com ​
  • 基金资助:

    国家自然基金项目(编号:81702002)

R446.6 Diagnostic efficacy of different neutrophils CD64 index in differential diagnosis of infection 

GAO Xuedan CAI Yihan,FENG Weihua,LI Yi,LUO Limei,WANG Lanlan,CAI Bei.    

  1. Department of Laboratory Medicine,West China Hospital of Sichuan University,Chengdu 610041,China

  • Online:2021-06-10 Published:2021-06-10
  • Contact: CAI Bei E⁃mail:evacaiayou@126.com

摘要:

目的 探讨改良中性粒细胞 CD64(nCD64)指数与传统 nCD64 指数鉴别诊断感染的临床应 用效能差异。方法 纳入自身免疫性疾病(AID)患者 32 例、血液肿瘤患者 32 例、急诊发热患者 59 例及健 康体检者 41 例。所有患者中确诊感染者 76 例,非感染者 47 例。采用流式细胞术检测外周血淋巴细胞、单核细胞和中性粒细胞的 CD64 荧光强度,计算改良 nCD64 指数和传统 nCD64 指数并比较两种指数对感染的鉴别诊断效能。结果 感染患者的改良 nCD64 指数和传统 nCD64 指数均显著高于非感染患者及健康体检者(均 P < 0.05);两种指数鉴别感染的 AUC 分别为 0.782 0.770(均 P < 0.05),最佳临界值分别为 1.00 4.74。传统指数仅在 AID 中具有较好的诊断效能(AUC=0.887,P < 0.05),改良指数在三类患者中均 有较好的诊断效能(AUC > 0.75,P < 0.05)。结论 两种 nCD64 指数对感染的鉴别诊断均有一定的临床 价值,且二者在自身免疫性疾病中诊断价值最高,改良 nCD64 指数较传统 nCD64 指数在急诊发热患者和 血液肿瘤中有更高的诊断效能。

关键词:

感染, 中性粒细胞CD64指数, 自身免疫性疾病, 血液肿瘤

Abstract:

Objective To explore the difference of clinical significance of modified neutrophil CD64 (nCD64)index and traditional nCD64 index in diagnosing infection. Methods We include 32 patients with auto⁃ immune diseases(AID),32 patients with hematologic tumors,59 patients in the emergency department and 41 healthy cases.Among which 76 were diagnosed with infection and 47 were non ⁃infected. Fluorescence intensity of CD64 on the peripheral blood lymphocytes,monocytes and neutrophils was detected by flow cytometry. The modi⁃ fied nCD64 index and the traditional nCD64 index were calculated and were used to make a ROC analysis. Results The modified nCD64 index and the traditional nCD64 index in infected patients were significantly higher than those in non⁃infected patients and healthy control(all P < 0.05). The AUCs of modified nCD64 indexes and traditional nCD64 index were 0.782 and 0.770,respectively(all P < 0.05),and their optimal cut⁃off values were 1.00 and 4.74,respectively. The traditional nCD64 index only had good diagnostic efficacy in AID patients(AUC = 0.887 P < 0.05). The modified index had preferable diagnostic efficacy in all three diseases(all AUCs > 0.75,P < 0.05). Conclusion Both modified nCD64 index and the traditional nCD64 index have potential diagnostic efficacy in the differential diagnosis of infection,and their diagnostic values are best in AID. The modified nCD64 index is more valuable in auxiliary diagnosing infection in patients with fever symptom from emergency department or patients with hematological malignancies than the traditional nCD64 index. 

Key words:

infection, neutrophils CD64 index, autoimmune diseases, hematologic tumors