流式细胞仪分析指标与传统感染指标在早产儿感染早期诊断中的比较

摘要

目的：比较流式细胞仪分析指标与传统感染指标在早产儿感染早期诊断中的临床应用。方法将60例早产儿根据其临床症状和实验室结果分为感染组（n＝29）与及非感染组（n＝31）。采用BD FACSCanto Ⅱ流式细胞仪检测CD11b、CD64、CD45RO ，体液及分泌物的培养采用BACTEC 9120全自动血液培养系统，血常规及超敏C反应蛋白（hs-CRP）检测分别采用Sys-mex XE-5000全自动血细胞分析仪及i-CHROMA Reader免疫荧光分析仪。用受试者工作特征（ROC）曲线分析各指标在早产儿感染中的诊断价值，计算其在早产儿早期感染诊断中的敏感性、特异性、阳性预测值及阴性预测值。结果出生后第1天，感染组早产儿中性粒细胞CD11b、CD64，单核细胞CD64及hs-CRP水平显著高于非感染组（P＜0．05）。两组早产儿CD45RO、WBC、中性粒细胞绝对数及百分比的差异无统计学意义（ P＞0．05）。中性粒细胞CD64、单核细胞 CD64、hs-CRP的 ROC曲线下面积（AUC）＞0．7，它们在早产儿感染的早期诊断中有较高价值，三者联合检测的最高敏感性、特异性、阳性预测值及阴性预测值分别为79．31％、96．78％、83．34％及75．00％。结论流式细胞仪分析指标在早产儿感染的早期诊断中具有较好的临床应用价值。%Objective To compare the clinical application of FACS analysis indicators and traditional infection indicators in early diagnosis of infection in premature infants .Methods 60 premature infants were divided into the infected group (n=29) and non-in-fected group(n=31) according to their clinical symptoms and laboratory results .BD FACSCanto Flow Cytometry was employed to detect CD11b ,CD64 and CD45RO ,BACTEC 9120 Automated Blood Culture System was used to conduct body fluids and secretions culture .Sysmex XE-5000 Automated Hematology Analyzers and i-CHROMA Reader Immunofluorescence Analyzer were adopted to conduct the complete blood count test and hypersensitive C-reactive protein (hs-CRP) detection ,respectively .Receiver operator characteristic(ROC) curve was used to analyze the diagnostic value of indexes above in preterm infants with infection ,and their sen-sitivity ,specificity ,positive predictive value and negative predictive value were calculated .Results On the first day after birth ,neu-trophil CD11b ,CD64 ,monocyte CD64 and hs-CRP levels of preterm infants in infection group were obviously higher than those in non-infection group(P<0 .05) .Differences of CD45RO ,WBC ,neutrophil absolute and percentage between the two groups showed no statistical significance(P>0 .05) .ROC area under the curve(AUC)>0 .7 was found in Neutrophil CD64 ,monocyte CD64 and hs-CRP ,which had higher value in early diagnosis of infection in premature infants .The highest sensitivity ,specificity ,positive pre-dictive value and negative predictive value were 79 .31% ,96 .78% ,83 .34% and 75 .00% ,respectively .Conclusion FACS analysis indicators has better clinical value in the early diagnosis of infection in premature infants .