天津医药

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中性粒细胞粘附因子CD11b与CD64表达对新生儿感染早期诊断价值的研究

郝丽红1,郭静1,刘晓军2,张芳3,许俐1,麻庆荣3,张文双1,高海涛1   

  1. 1. 天津市儿童医院
    2. 儿童医院新生儿科
    3. 天津市儿童医院新生儿科
  • 收稿日期:2010-04-21 修回日期:2010-11-23 出版日期:2011-04-15 发布日期:2011-04-15
  • 通讯作者: 郝丽红

Studying neutrophil adhesion molecule CD11b and CD64 expression on the value of early diagnosis of neonatal infection.

  • Received:2010-04-21 Revised:2010-11-23 Published:2011-04-15 Online:2011-04-15

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摘要： 摘要 目的 探讨外周血中性粒细胞粘附因子CD11b 、CD64表达在早期诊断新生儿细菌感染及疗效评价中的价值。方法 2005年5月～2008年5月在我院新生儿病房住院的疑为细菌感染的患儿63例。记录其临床表现、血培养、脑脊液培养结果，检测5项非特异性指标。败血症组33例，非败血症感染组30例，对照组15例。各组患儿在入院后24～48小时内取外周静脉血1ml，采用流式细胞仪检测中性粒细胞CD11b 、CD64 表达。败血症组在恢复期（治疗1周后）复查。结果 败血症组中性粒细胞CD11b表达水平高于非败血症感染组和对照组（P<0.05）。非败血症感染组与对照组之间差异无统计学意义（P=1.000）。败血症组中性粒细胞CD64表达水平显著高于非败血症感染组和对照组（P<0.05），非败血症感染组高于对照组（P<0.05）。败血症组在恢复期CD11b 、CD64表达水平下降有统计学意义（P<0.05）。败血症组以CD11b≥320MFI、CD64 ≥20MFI为临界值阳性标准，CD11b、CD64对诊断败血症的灵敏度分别为72.73%和75%，特异度分别为94.74%和80.49%。CD11b和CD64在革兰氏阳性菌和革兰氏阴性菌感染时表达差异无统计学意义。结论　应用流式细胞术测定外周血中性粒细胞粘附因子CD11b、CD64，可作为早期诊断新生儿败血症的实验室依据之一，动态观察其水平变化，对判断感染程度、治疗效果的评价具有较高的临床应用价值。

关键词: 新生儿, 败血症, CD11b, CD64, 流式细胞术

Abstract: [Abstract] Objective Investigating the value of the peripheral blood neutrophil adhesion molecule CD11b and CD64 expression in the early diagnosis of neonatal bacterial infection and evaluating its efficacy. Methods Sixty-three suspected neonatal bacterial infection cases who were hospitalized from May 2005 ~ May 2008 were recruited into the study. Recorded their clinical manifestations, blood culture, cerebrospinal fluid culture results and five non-specific indices were measured for each patient. The patients were divided into sepsis group (n = 33) and non-septisemic infection group (n =30).Fifteen hospitalized neonates with noninfectious diseases were enrolled as controls (n = 15). 1ml peripheral blood would be taken from each group patients within 24～48h after they hospitalized. The levels of peripheral blood neutrophil CD11b and CD64 were measured by flow cytometry. During the recovery period (treatment 1 week later) for sepsis group measured again. Results The levels of peripheral blood neutrophil CD11b in sepsis group were higher than those of non-septisemic infection group and control group (P <0.05 ). There were no difference between non-septisemic infection group and control group (P = 1.000). The expressions of neutrophil CD64 in sepsis group were significantly higher than those of non-sepsis infection group and the control group (P <0.05), non-septisemic infection group were higher than those of control group (P <0.05). The levels of CD11b and CD64 of the cases with septicemia significantly decreased on the restoration stage (P<0.05). Positive critical value of sepsis group were CD11b≥320MFI, CD64≥20MFI , which for diagnosis sepsis showed sensitivity and specificity were 72.73% and 75%, 94.74% and 80.49%，respectively. The expressions of neutrophil CD11b and CD64 have no statistics significance between Gram-positive bacteria and gram-negative bacteria infection. Conclusion The expression of peripheral blood neutrophil adhesion molecule CD11b and CD64 measured by the whole blood flow cytometry can be used as one of the laboratory index for early diagnosis neonatal sepsis. For the neonatal sepsis, the serial measurements of CD11b and CD64 expression have a high value on evaluated infection severity and observaed therapy reactions.Observed on the infection to determine the extent of the evaluation of treatment with a more a high clinical value.

Key words: neonate, sepsis, CD11b, CD64, flow cytometry