目的 探讨CD64、血清降钙素原(PCT)在新生儿败血症诊断中的价值.方法 败血症组36例在入院初及恢复期采空腹静脉血,应用流式细胞术测定CD64、应用固相免疫色谱法测定PCT,同时行外周血C-反应蛋白(CRP)测定,并在入院接受抗生素治疗前作血培养.非感染组22例和健康对照组26例一次性采血测定CD64、PCT和CRP.结果 败血症组CD64水平为(60.37 ± 22.70)平均荧光强度(MFI),明显高于对照组的(23.14 ± 5.10)MFI(P ＜ 0.01);败血症组PCT水平为(24.12 ± 20.37)μg/L,明显高于对照组的(0.30 ± 0.19)μg/L(P ＜ 0.01);恢复期CD64、PCT水平均明显下降(P均＜ 0.01).以CD64 ≥ 35 MFI、PCT ≥ 0.5 μg/L、CRP ≥ 8 mg/L为阳性标准,三项指标对诊断新生儿败血症的敏感度分别为95.7%、94.4%、69.6%,特异度分别为95.8%、84.6%、75.0%.结论 CD64、PCT可作为新生儿败血症早期诊断、判断病情的重要指标.%Objective To explore the value of neutrophil CD64 and procalcitonin (PCT) for the early diagnosis of neonatal septicenfia. Methods The neutrophil CD64 measured by flow cytometry, serum PCT detected by direct immunofluorescence technique, and peripheral serum C-reactive protein ( CRP) determined by rate nephelometry at admission and the recovery stage, and the blood cultured before antibiotic treatment were undertaken in 36 neonates with septicemia, respectively. The blood samples were collected only once for the determination of CD64, PCT and CRP in 22 non-infection neonates and 26 healthy neonates. Results The levels of neutrophil CD64 (60.37 ± 22.70 median fluorescence intensity (MFI) vs. 23.14 ± 5.10 MFI, P ＜0.01) and serum PCT (0.30 ± 0.19 μg/ L vs. 24.12 ± 20.37 μg/L, P ＜ 0.01) were significantly higher in neonates with septicemia than those in the healthy control neonates. However, the levels of CD64 and PCT in septic neonates decreased significantly in the recovery stage (P ＜ 0.01 for all). If CD64 ≥ 35 MFI, PCT ≥0.5 μg/L, CRP ≥ 8 mg/L were used as the positive criterion, the sensitiyties would be 95.7％, 94.4％ and 69.6％ and the speeificities be 95.8％, 84.6％ and 75.0％ for CD64, PCT and CRP, respectively. Conclusions It is feasible that CD64 and PCT can be as important: markers for the early diagnosis of neonatal sepsis, and also potentially applicable for the judgement of the illness state.
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