| 外周血CD64指数对脓毒症急性肺损伤的早期诊断价值 |
| 投稿时间：2016-02-05 修订日期：2016-02-23 点此下载全文 |
| 引用本文：罗成,余皓月,封明霞,代伟,胡佳勇.外周血CD64指数对脓毒症急性肺损伤的早期诊断价值[J].医学研究杂志,2016,45(9):98-101 |
| DOI：
10.11969/j.issn.1673-548X.2016.09.026 |
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| 作者 | 单位 | E-mail | | 罗成 | 1. 400042 重庆, 第三军医大学大坪医院野战外科研究所呼吸内科
2. 400042 重庆, 第三军医大学大坪医院野战外科研究所心血管内科 | | | 余皓月 | 1. 400042 重庆, 第三军医大学大坪医院野战外科研究所呼吸内科
2. 400042 重庆, 第三军医大学大坪医院野战外科研究所心血管内科 | | | 封明霞 | 1. 400042 重庆, 第三军医大学大坪医院野战外科研究所呼吸内科
2. 400042 重庆, 第三军医大学大坪医院野战外科研究所心血管内科 | | | 代伟 | 1. 400042 重庆, 第三军医大学大坪医院野战外科研究所呼吸内科
2. 400042 重庆, 第三军医大学大坪医院野战外科研究所心血管内科 | | | 胡佳勇 | 1. 400042 重庆, 第三军医大学大坪医院野战外科研究所呼吸内科
2. 400042 重庆, 第三军医大学大坪医院野战外科研究所心血管内科 | hujiayongcq01@163.com |
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| 中文摘要:目的 探讨外周血CD64指数在脓毒症急性肺损伤患者中的表达及早期诊断价值。方法 以250例脓毒症患者为研究对象，按临床表现分为脓毒症普通组（n=180）和脓毒症急性肺损伤组（n=70），同时选取50例体检者为健康对照组。采用流式细胞术检测外周血CD64，同时检测C反应蛋白（CRP）及白细胞计数（WBC）。分别比较各组患者外周血CD64指数及CRP、WBC水平的差异以及CD64指数水平与CRP、WBC水平的相关性，评价外周血CD64指数水平对脓毒症急性肺损伤患者的早期诊断价值。结果 脓毒症急性肺损伤组患者外周血CD64指数、CRP水平显著高于脓毒症普通组和健康对照组（P<0.05），而脓毒症急性肺损伤组患者WBC水平与脓毒症普通组比较，差异无统计学意义（P>0.05）。经过相应治疗后，脓毒症急性肺损伤组患者外周血CD64指数、CRP及WBC水平均较治疗前显著降低（P<0.05）；相关性分析显示，外周血CD64指数与CRP水平呈正相关（r=0.85，P<0.01），而与WBC水平无显著相关性（r=0.034，P>0.05）。ROC曲线分析显示，以外周血CD64指数>6.36作为早期诊断脓毒症急性肺损伤界限时，诊断脓毒症急性肺损伤的敏感度和特异性分别为84.8%和88.5%，ROC曲线下面积（AUC）为0.879（95% CI：0.792~0.913）。结论 CD64在脓毒症急性肺损伤患者中高表达，其可作为早期诊断脓毒症急性肺损伤患者的有效指标，具有一定的临床运用价值。 |
| 中文关键词:CD64指数 脓毒症 急性肺损伤 诊断 |
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| Early Diagnostic Value of CD64 Index in Peripheral Blood of Sepsis with Acute Lung Injury |
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| Abstract:Objective To investigate the expression levels and early diagnosis value of CD64 index of peripheral blood cells in sepsis patients with acute lung injury. Methods A tatal of 250 cases of patients with sepsis were enrolled in the study. The patients with sepsis were divided into a mild sepsis group (n=180) and a sepsis with acute lung injury (n=70) according to the clinical manifestations, and 50 cases volunteers were served as healthy control group. CD64 was measured by flow cytometry. C-reactive protein (CRP) and white blood cell count (WBC) were detected. The CD64 index, CRP and WBC levels in every group were compared. The correlation between CD64 index and CRP, and WBC were analyzed. The early diagnosis value of CD64 index in sepsis with acute lung injury patients was assessed. Results The CD64 index and CRP levels of sepsis with acute lung injury group were higher than those of the mild group and control group (P<0.05). Compared with the mild group, there was no difference in the WBC levels in sepsis patients with acute lung injury (P>0.05). After appropriate treatment, the CD64 index, CRP, and WBC levels in sepsis patients with acute lung injury were significant lower than before treatment (P<0.05). The correlation analysis showed that CD64 index in peripheral blood and CRP levels were positively correlated (r=0.85,P<0.01), but WBC was not (r=0.034,P>0.05). The ROC curve analysis showed that when CD64 index>6.36 was considered as the boundary for diagnosis in sepsis patients with acute lung injury, the sensitivity and specificity of diagnosis were 84.8% and 88.5%, the area under the ROC curve (AUC) was 0.879 (95%CI:0.792-0.913). Conclusion The expression of CD64 is higher in sepsis patients with acute lung injury, which can be used as an effective indicator for early diagnosis of sepsis patients with acute lung injury.It has an important clinical application value. |
| keywords:CD64 index Sepsis Acute lung injury Diagnosis |
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