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目的探讨CD64在肺结核和肺部细菌感染鉴别诊断中的价值。方法选取单纯肺结核患者100例(Ⅱ组)。另选同期肺部细菌感染患者100例(Ⅲ组)。同期体健中心健康志愿者100例(Ⅰ组)。观察3组患者入组48h内静脉血CD64及降钙素原(PCT)、C反应蛋白(CRP)。结果 3组CD64、PCT、CRP水平由高到低均为Ⅲ组、Ⅱ组、Ⅰ组,差异均有统计学意义(P<0.05)。将Ⅰ组、Ⅱ组的CD64、PCT及CRP数据作ROC曲线,可见曲线下面积PCT(0.884)>CD64(0.872)>CRP(0.782),与标准面积0.5相比均有统计学意义(P<0.05)。将Ⅰ组、Ⅲ组的CD64、PCT及CRP数据作ROC曲线,可见曲线下积CD64(0.965)>PCT(0.933)>CRP(0.885),与标准面积0.5相比均有统计学意义(P<0.05)。结论 CD64在肺部感染患者中呈高水平表达,明显高于肺结核患者及健康志愿者,对于鉴别肺部感染和肺结核具有一定价值。CD64在诊断肺部细菌感染的判定价值上与PCT相仿,优于CRP,可作为判断肺部细菌感染的辅助检查指标。
Objective To investigate the value of CD64 in the differential diagnosis of pulmonary tuberculosis and pulmonary bacterial infection. Methods One hundred patients with simple pulmonary tuberculosis were selected (group Ⅱ). Another 100 cases of patients with bacterial infection during the same period (group Ⅲ). In the same period, there were 100 healthy volunteers in the health center (group Ⅰ). The levels of CD64, procalcitonin (PCT) and C-reactive protein (CRP) in venous blood of the three groups were observed within 48 hours. Results The levels of CD64, PCT and CRP in three groups were all in the groups of Ⅲ, Ⅱ and Ⅰ from high to low (P <0.05). The ROC curves of CD64, PCT and CRP in group Ⅰ and group Ⅱ showed that the area under the curve was 0.884 and 0.872 respectively, and the area under the curve was 0.782, which was significantly lower than that of standard area 0.5 (P < 0.05). The CD64, PCT and CRP data of group Ⅰ and group Ⅲ were used as ROC curve, showing that CD64 (0.965)> PCT (0.933)> CRP (0.885) under the curve were statistically significant compared with the standard area of 0.5 (P < 0.05). Conclusion CD64 is highly expressed in patients with pulmonary infection, which is significantly higher than those in patients with pulmonary tuberculosis and healthy volunteers. It is of value in differentiating pulmonary infection from pulmonary tuberculosis. CD64 in the diagnosis of lung bacterial infection with the value of PCT similar, better than CRP, can be used as a diagnostic indicator of lung bacterial infections.