CD64指数、WBC在小儿败血症早期诊断与预后判断中的应用价值被引量：8

The application significance of CD64 index and WBC for the early diagnosis and prognosis of sepsis in children

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摘要目的探讨外周血CD64指数、白细胞(WBC)计数在小儿败血症早期诊断、预后监测中的价值。方法选取小儿败血症患儿57例、一般感染肺炎患儿65例、健康对照者36名,应用流式细胞术检测CD64指数,血液分析仪检测WBC。结果 CD64指数、WBC计数在败血症组、肺炎组和健康对照组之间差异有统计学意义(P<0.01);血培养阳性者CD64指数高于血培养阴性者(P<0.05);根据受试者工作特征(ROC)曲线,当CD64指数临界值取2.25时,敏感性为88%,特异性为85%;经治疗后CD64指数明显下降(P<0.01),但未降至正常水平,与对照组比较差异仍有统计学意义(P<0.01)。结论 CD64指数具有最佳的临床诊断价值,可以指导临床早期诊断和鉴别诊断小儿败血症,并可作为预后判断的指标。 Objective To investigate the significance of peripheral blood CD64 index and white blood cell （ WBC ） for the early diagnosis and prognosis monitoring of sepsis in children. Methods A total of 57 children with sepsis, 65 children with pneumonia and 36 healthy children were enrolled. The index of CD64 was determined by flow cytometry, and WBC was determined by haematology analyzer. Results The index of CD64 and WBC in sepsis, pneumonia and healthy control groups had statistical significance （ P 〈 0.01 ）. The index of CD64 in the blood culture positive was significantly higher than that in the blood culture negative （P 〈 0.05 ）. According to the receiver operating characteristic （ROC） curve, when the cut-off value in the diagnosis of sepsis was 2.25, the sensitivity was 88% , and the specificity was 85%. After treatment, the index of CD64 decreased significantly （P 〈0.01 ） , but not to be the normal level, and the difference was statistically significant compared with the healthy control group （ P 〈 0.01 ）. Conclusions The index of CD64 has the clinical significance for the early diagnosis and prognosis of sepsis in children.

作者汪文娟王浩陈哲

机构地区宁波卫生职业技术学院奉化人民医院检验科宁波鄞州人民医院

出处《检验医学》 CAS 2013年第5期416-419,共4页 Laboratory Medicine

关键词 CD64指数白细胞败血症 CD64 index White blood cell Sepsis

分类号 R446.62 [医药卫生—诊断学]

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参考文献14

1Bhattacharya S. Blood culture in India:a proposal for a national programme for early detection of sepsis [ J ]. Indian J Med Microbiol,2005, 23(4) :220-226.
2Kerschen E J, Fernandez JA, Cooley BC, et al. En- dotoxemia and sepsis mortality reduction by non-anti- coagulant activated protein C [ J ]. J Exp Med, 2007, 204(10) :2439-2448.
3Riedemann NC, Guo RF, Ward PA. The enigma of sepsis[J]. J Clin Invest, 2003, 112(4) : 460- 467.
4Griffin MP, Moorman JR. Toward the early diagnosis of neonatal sepsis and sepsis-like illness using novel heart rate analysis [ J ]. Pediatrics, 2001,107 ( 1 ) :97-104.
5Icardi M, Erickson Y , Kilborn S ,et al. CD64 index provides simple and predictive testing for detection and monitoring of sepsis and bacterial infection in hospital patients [ J ]. J Clin Microbiol, 2009, 47 (12) :3914-3019.
6Fossati G, Buckna11 RC, Edwards SW. Fcgamma receptors in autoimmune diseases [ J ]. Eur J Clin Invest, 2001, 31(9):821-831.
7Barth E, Fischer G, Schneider EM, et al. Differences in the expression of CD64 and mCD14 on poly- morphonuclear cells and on monocytes in patients with septic shock[J]. Cytokine, 2001, 14 (5) :299-302.
8Choo YK, Cho HS, Seo IB, et al. Comparison of the accuracy of neutrophil CD64 and C-reactive protein as a single test for the early detection of neonatal sepsis[J]. Korean J Pediatr, 2012, 55(1):11-17.
9Gros A, Roussel M, Sanvadet E, et al. The sensitivity of neutrophil CI)64 expression as a biomarker of bacterial infection is low in critically ill patients [ J ]. Intensive Care Med, 2012, 38(3) :445-452.
10Groselj-Grenc M, Ihan A, Pavcnik-Arnol M, et al. Neutrophil and monocyte CD64 indexes, lipopoly- saccharide-binding protein, procalcitonin and C-reac- tive protein in sepsis of critically ill neonates and children[J]. Intensive Care Med, 2009,35 ( 11 ) : 1950-1958.

二级参考文献13

1郝玲,李艳芝.CD64和新生儿感染[J].国外医学（儿科学分册）,2005,32(3):176-178. 被引量：8
2邵洁,黄新文,孙眉月,杜立中,汤永民,乐园罗.新生儿败血症外周血中性粒细胞CD_(64)的表达及其意义[J].中华儿科杂志,2005,43(7):510-513. 被引量：24
3Ceccon ME, Vaz FA, Diniz EM, et al. Interleukins 6 and C-reactive protein for the diagnosis of late onset sepsis in the newborn infant [ J ]. Rev Assoc Med Bras. 2006,52(2) :79-85.
4Davis BH. Improved diagnostic approaches to infection/ sepsis detection [ J]. Expert Rev Mol Diagn, 2005,5 (2) :193-207.
5Ng PC, Li G, Chui KM, et al. Neutrophil CD64 is a sensitive diagnostic marker for early-onset neonatal infection[ J]. Pediatr Res,2004,56(5 ) :796-803.
6Zhang G, Qiao S, Li Q, et al. Molecular cloning and expression of the porcine high-affinity immunoglobulin G Fc receptor (FcgammaRI)[J]. Immunogenetics, 2006, 58(10) :845-849.
7Danikas DD, Karakantza M, Theodorou GL,et al. Prognostic value of phagocytic activity of neutrophils and monocytes in sepsis. Correlation to CD64 and CD14 antigen expression[J]. Clin Exp Immunol, 2008, 154 ( 1 ) : 87-97.
8Allen E, Bakke AC,Purtzer MZ, et al. Neutrophil CD64 expression : distinguishing acute inflammatory autoimmune disease from systemic infections[J]. Ann Rheum Dis,2002,61 (6) : 522-525.
9Davis BH,Olsen SH, Ahmad E, et al. Neutrophil CD64 is an improved indicator of infection or sepsis in emergency department patients [J].Arch Pathol Lab Med, 2006, 130 (5) :654-661.
10Nuutila J, Hohenthal U, Laitinen I, et al. Simultaneous quantitative analysis of FcgammaRI (CD64) expression on neutrophils and monocytes: a new, improved way to detect infections [ J]. J Immunol Methods, 2007, 328 (1-2) : 189-200.