脓毒症患儿中性粒细胞CD64 CD11b分子表达及临床意义探讨

doi:10.3969/j.issn.1002-1949.2018.10.011

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摘要目的评价外周血中性粒细胞CD64、CD11b表达在脓毒症患儿早期诊断中的应用价值。方法 99例研究对象依据病情不同分为三组：脓毒症组(44例)、非脓毒症感染组(33例)及正常对照组(22例)。采用流式细胞术检测外周血中性粒细胞CD64、CD11b的平均荧光强度(median fluorescence intensity， MFI)，同时检测外周血 C反应蛋白(C-reactive protein， CRP)水平。结果脓毒症组患儿中性粒细胞CD64、CD11b表达水平及CRP均较非脓毒症感染组及正常对照组高(P均＜0.01)。二元Logistic回归分析，CD64第二分位组发生脓毒症的风险是第一分位组的3.750倍，第三分位组发生脓毒症的风险是第一分位组的4.808倍；CD11b第三分位组发生脓毒症的风险是第一分位组的4.600倍。以ROC曲线确定CD64的最佳截断值为6415MFI，其诊断脓毒症的敏感度和特异度分别为91.7%、72.5%，有较高的诊断价值；以ROC曲线确定CD11b的最佳截断值为1667MFI，诊断脓毒症的敏感度和特异度分别为70.8%、56.9%；CD64联合检测CRP诊断脓毒症的敏感度和特异度为97.9%、84.3%。结论脓毒症患儿外周血中性粒细胞表面标志物CD64、CD11b平均荧光强度表达升高，尤其CD64联合检测CRP诊断脓毒症患儿有更高的敏感度及阴性预测值，减少漏诊率，可以作为脓毒症患儿早期诊断依据，指导临床治疗。

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	赖乾坤
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关键词 ：脓毒症, CD64, CD11b, 儿童, C-反应蛋白

通讯作者: 刘光华（1962-），男，硕士，主任医师，E-mail：liugh1962815@hotmail.com。

作者简介: 赖乾坤(1984-)，男，硕士，主治医师，E-mail:danuoyi@163.com。

引用本文:

赖乾坤，刘光华，叶红，王世彪，毛晓丹. 脓毒症患儿中性粒细胞CD64 CD11b分子表达及临床意义探讨[J]. 中国急救医学, 2018, 38(10): 885-889.
Lai Qian-kun， Liu Guang-hua, Ye Hong, Wang Shi-biao, Mao Xiao-dan. Expression and clinical significance of CD64 and CD11b in children with sepsis. Chinese Journal of Critical Care Medicine, 2018, 38(10): 885-889.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.10.011 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I10/885

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