PCT、HNL和CD64水平对细菌性感染的诊断价值
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摘要
目的探讨降钙素原(PCT)、人中性粒细胞载脂蛋白(HNL)和中性粒细胞CD64水平对细菌性感染的诊断价值。方法选取感染患者86例,其中44例确诊为单纯细菌性感染(细菌感染组)、42例确诊为单纯病毒性感染(病毒感染组),以40名体检健康者作为正常对照组。同时检测3组血液PCT、HNL、CD64水平及白细胞(WBC)计数。采用受试者工作特征(ROC)曲线评估PCT、HNL、CD64及WBC计数诊断细菌性感染的价值。结果细菌感染组PCT、HNL、CD64水平及WBC计数显著高于病毒感染组和正常对照组(P<0.05),病毒感染组CD64水平及WBC计数显著高于正常对照组(P<0.05)。PCT、HNL、CD64及WBC计数诊断细菌性感染的敏感性分别为79.55%、84.09%、81.82%、77.27%,特异性分别为83.33%、88.09%、85.71%、85.71%。ROC曲线分析结果显示,HNL、CD64、PCT及WBC计数诊断细菌性感染的曲线下面积(AUC)分别为0.914、0.900、0.837、0.748。结论 PCT、HNL、CD64可用于细菌性感染的诊断,HNL的诊断价值最大。
Objective To investigate the roles of procalcitonin(PCT),human neutrophil lipocalin(HNL)and neutrophil CD64 in the diagnosis of bacterial infection. Methods A total of 86 patients with suspected bacterial infection were enrolled. There were 44 cases of bacterial infection group,42 cases of viral infection group and 40 cases of healthy subjects(healthy control group). The levels of PCT,HNL,CD64 and white blood cell(WBC)count of bacterial infection,viral infection and healthy control groups were determined,and the diagnostic roles of PCT,HNL and CD64 were evaluated by receiver operating characteristic(ROC)curve. Results Compared with viral infection and healthy control groups,PCT,HNL and CD64 levels and WBC counts in bacterial infection group were increased(P<0.05). CD64 level and WBC count were increased in viral infection group compared with healthy control group(P<0.05). The sensitivities of PCT,HNL,CD64 and WBC count for the diagnosis of bacterial infection were 79.55%,84.09%,81.82% and 77.27%,respectively. The specificities were 83.33%,88.09%,85.71% and 85.71%,respectively. The areas under ROC curves(AUC) of HNL,CD64,PCT and WBC count were 0.914,0.900,0.837 and 0.748,respectively. Conclusions HNL,CD64,PCT and WBC count can be used in the diagnosis of bacterial infection. HNL plays a role for the diagnosis of bacterial infection.
Objective To investigate the roles of procalcitonin(PCT),human neutrophil lipocalin(HNL)and neutrophil CD64 in the diagnosis of bacterial infection. Methods A total of 86 patients with suspected bacterial infection were enrolled. There were 44 cases of bacterial infection group,42 cases of viral infection group and 40 cases of healthy subjects(healthy control group). The levels of PCT,HNL,CD64 and white blood cell(WBC)count of bacterial infection,viral infection and healthy control groups were determined,and the diagnostic roles of PCT,HNL and CD64 were evaluated by receiver operating characteristic(ROC)curve. Results Compared with viral infection and healthy control groups,PCT,HNL and CD64 levels and WBC counts in bacterial infection group were increased(P<0.05). CD64 level and WBC count were increased in viral infection group compared with healthy control group(P<0.05). The sensitivities of PCT,HNL,CD64 and WBC count for the diagnosis of bacterial infection were 79.55%,84.09%,81.82% and 77.27%,respectively. The specificities were 83.33%,88.09%,85.71% and 85.71%,respectively. The areas under ROC curves(AUC) of HNL,CD64,PCT and WBC count were 0.914,0.900,0.837 and 0.748,respectively. Conclusions HNL,CD64,PCT and WBC count can be used in the diagnosis of bacterial infection. HNL plays a role for the diagnosis of bacterial infection.
引文
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[10]张淑青,袁宝军,李超,等.NLR、CD64和PCT检测在血液细菌感染中的价值[J].中国实验诊断学,2015,19(8):1314-1317.
[11]KIKUCHI-TAURA A,YURA A,TSUJI S,et al.Monocyte CD64 expression as a novel biomarker for the disease activity of systemic lupus erythematosus[J].Lupus,2015,24(10):1076-1080.
[12]牟娜,谢春艳,牟佳,等.降钙素原、人中性粒细胞载脂蛋白和中性粒细胞CD64检测在细菌性感染早期诊断中的应用[J].中国感染与化疗杂志,2017,17(6):633-636.
[13]MUZLOVIC I,IHAN A,STUBLJAR D,et a1.CD64index on neutrophils can diagnose sepsis and predict 30-day survival in subjects after ventilator-associated pneumonia[J].J Infect Dev Ctries,2016,10(3):260-268.
[2]降钙素原急诊临床应用专家共识组.降钙素原(PCT)急诊临床应用的专家共识[J].中华急诊医学杂志,2012,21(9):944-951.
[3]KAUR K,MAHAJAN R,TANWAR A.A novel marker procalcitonin may help stem the antibiotic overuse in emergency setting[J].Int J Appl Basic Med Res,2013,3(2):77-83.
[4]VENGE P,DOUHAN-H?KANSSON L,GARWICZ D,et al.Human neutrophil lipocalin as a superior diagnostic means to distinguish between acute bacterial and viral infections[J].Clin Vaccine Immunol,2015,22(9):1025-1032.
[5]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[6]贾芙蓉,张宇,王超,等.人中性粒细胞载脂蛋白在急性细菌与病毒感染鉴别诊断中的临床意义[J].中国生物制品学杂志,2012,25(1):87-90.
[7]张金平.血液白细胞参数、C-反应蛋白和降钙素原在血液感染诊断中的应用[J].温州医科大学学报,2015,45(6):454-456.
[8]YU Z,JING H,HONGTAO P,et a1.Distinction between bacterial and viral infections by serum measurement of human neutrophil lipocalin(HNL)and the impact of antibody selection[J].J Immunol Methods,2016,432:82-86.
[9]金宇亭,高海翟,张宇,等.人中性粒细胞载脂蛋白的临床应用进展[J].广东医学,2015,36(11):1778-1780.
[10]张淑青,袁宝军,李超,等.NLR、CD64和PCT检测在血液细菌感染中的价值[J].中国实验诊断学,2015,19(8):1314-1317.
[11]KIKUCHI-TAURA A,YURA A,TSUJI S,et al.Monocyte CD64 expression as a novel biomarker for the disease activity of systemic lupus erythematosus[J].Lupus,2015,24(10):1076-1080.
[12]牟娜,谢春艳,牟佳,等.降钙素原、人中性粒细胞载脂蛋白和中性粒细胞CD64检测在细菌性感染早期诊断中的应用[J].中国感染与化疗杂志,2017,17(6):633-636.
[13]MUZLOVIC I,IHAN A,STUBLJAR D,et a1.CD64index on neutrophils can diagnose sepsis and predict 30-day survival in subjects after ventilator-associated pneumonia[J].J Infect Dev Ctries,2016,10(3):260-268.