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目的探讨中性粒细胞CD11b、CD64在新生儿败血症诊断中的价值。方法2005年1月至2005年12月检测河北医科大学第一医院儿科36例败血症新生儿及26名健康新生儿中性粒细胞CD64、CD11b的表达水平和CRP质量浓度,比较各指标对诊断新生儿败血症的灵敏度、特异度、阳性预测值、阴性预测值和约登指数,评价它们对诊断该病的价值。结果(1)败血症组CD64、CD11b水平均明显高于对照组(P<0.01);(2)以CD64≥35MFI,CD11b≥1300MFI,CRP≥8mg/L为阳性标准,三指标对诊断败血症的灵敏度分别为95.7%、82.6%、69.6%,CD64的特异度95.8%、阳性预测值95.6%、阴性预测值95.4%、约登指数91.5%;(3)CD11b、CD64水平在治疗前后差异有显著意义,P均<0.01。结论中性粒细胞CD11b、CD64可作为新生儿败血症早期诊断、判断病情的可靠指标。
Objective To investigate the value of neutrophil CD11b and CD64 in the diagnosis of neonatal sepsis. Methods From January 2005 to December 2005, the expression levels of CD64 and CD11b and the concentrations of CRP in neutrophils of 36 neonates with sepsis and 26 healthy newborns in pediatrics of the First Hospital of Hebei Medical University from January 2005 to December 2005 were detected. The sensitivity, specificity, positive predictive value, negative predictive value and Youden index of sepsis were evaluated and their value in diagnosing the disease was evaluated. Results (1) The levels of CD64 and CD11b in sepsis group were significantly higher than those in control group (P <0.01). (2) The sensitivity of three indexes to the diagnosis of sepsis was positive with CD64≥35MFI, CD11b≥1300MFI and CRP≥8mg / L (95.7%, 82.6%, 69.6% respectively). The specificity of CD64 was 95.8%, the positive predictive value was 95.6%, the negative predictive value was 95.4% and the Youden index was 91.5%. (3) The levels of CD11b and CD64 were significantly different before and after treatment , P <0.01. Conclusion Neutrophils CD11b and CD64 can be used as early indicators of neonatal sepsis diagnosis and judgment.