流式细胞术检测中性粒细胞CD64指数在鉴别早期感染性疾病中的临床价值分析

摘要

目的 分析流式细胞术检测中性粒细胞CD64指数在鉴别早期感染性疾病中的临床价值.方法 选取我院2015年10月至2017年4月期间收治的感染性疾病患者200例,根据感染严重程度分为早期局部感染组(n=120)和脓毒血症组(n=80),另选同期入院体检的健康志愿者50例作为对照组.所有研究对象均于入院后24 ～ 48h内及治疗前进行血常规WBC检测和CRP测定,采用流式细胞仪多参数分析中性粒细胞CD64 (MESF)及中性粒细胞CD64指数,通过绘制受试者工作特征(ROC)曲线计算中性粒细胞CD64指数鉴别早期感染性疾病的灵敏度和特异性.结果 对照组、早期局部感染组、脓毒血症组中性粒细胞CD64及血清CRP、WBC水平依次显著升高,各组差异有统计学意义(P＜0.05).早期局部感染组中性粒细胞CD64指数与血浆CRP、WBC水平呈正相关(P＜0.05).中性粒细胞CD64指数、CRP、WBC的曲线下面积分别为0.896、0.757、0.629(P均＜0.05);与CRP、WBC相比,中性粒细胞CD64指数鉴别早期感染性疾病的灵敏度、特异性为97.39％、90.59％明显升高.结论 分析外周血中性粒细胞CD64指数对于早期感染性疾病的鉴别诊断有重要价值,其诊断效能明显优于血常规WBC和CRP检测.%Objective To analyze the clinical value of flow cytometry in detecting neutrophil CD64 index in the identification of early infectious diseases.Methods 200 cases of patients with infectious diseases admitted in our hospital from October 2015 to April 2017 were selected for this study and divided into the early local infection group (n =120) and the sepsis group (n =80) according to the severity of infection,and other 50 healthy volunteers undermedical examination at the same time period were selected as control group.All subjects were treated with routine WBC and CRP examination before 24 to 48 hours after admission or before treatment.Two-parameter analysis of neutrophils CD64(MESF) and neutrophil CD64 index were performed by flow cytometry.The sensitivity and specificity of the neutrophil CD64 index in identifying early infectious diseases were calculated by plotting the receiver-operating characteristic (ROC) curve.Results The levels of CD64 and plasma CRP and WBC in the control group,the early local infection group and the sepsis group were progressively increased(P ＜ 0.05).There was a positive correlation between CD64 index and serum CRP and WBC levels in the early local infection group (P ＜ 0.05).The area under the curve of neutrophil CD64 index,CRP and WBC were 0.896,0.757,0.629,respectively (eachP ＜ 0.05).The sensitivity and specificity of neutrophil CD64 index for early infectious diseases were 97.39％ and 90.59％ respectively,which were higher compared with CRP and WBC.Conclusion The analysis of peripheral blood neutrophil CD64 index is of great value for the early diagnosis of infectious diseases,and the diagnostic efficiency is significantly better than blood routine WBC and CRP detection.