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目的探讨CD64、血清降钙素原(PCT)及C-反应蛋白(CRP)在新生儿败血症诊断中的意义。方法金华市人民医院新生儿科2014年6月-2016年6月收治的新生儿败血症患者56例(败血症组)、局部细菌感染患儿44例(局部细菌感染组)、非细菌感染患儿47例(非细菌感染组)及健康对照新生儿30例(健康对照组),采用流式细胞术检测外周血中性粒细胞膜表面CD64表达水平、固相免疫色谱法和速率散射比浊法测定血清中的PCT及CRP的含量。结果败血症组CD64指数、PCT和CRP均明显高于局部细菌感染组、非细菌感染组及健康对照组,差异有统计学意义(P<0.05)。当CD64荧光指数截断值为5.876时,其诊断灵敏度为92.86%,特异度为95.87%,均优于CRP、PCT及CRP单独诊断效率;当CD64指数、PCT及CRP三者联合使用时,灵敏度为98.21%,特异度为99.17%。结论 CD64指数、PCT及CRP联合检测能够提高对新生儿败血症早期诊断的敏感度和特异度,有助于细菌感染的早期发现。
Objective To investigate the significance of CD64, serum procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis of neonatal sepsis. Methods 56 cases of neonatal sepsis (sepsis group), 44 cases of local bacterial infection (local bacterial infection group), 47 cases of non-bacterial infection in Jinhua People’s Hospital neonatal department from June 2014 to June 2016 were enrolled in this study. (Non-bacterial infection group) and healthy control neonates (control group). Flow cytometry was used to detect the expression of CD64 in the peripheral blood neutrophil membrane surface. The levels of CD64 in peripheral blood were detected by solid phase immunosorbent assay and rate nephelometry PCT and CRP content. Results The CD64 index, PCT and CRP in sepsis group were significantly higher than those in local bacterial infection group, non-bacterial infection group and healthy control group (P <0.05). The diagnostic sensitivity of CD64 was 92.86% and the specificity was 95.87% when the cutoff value of CD64 fluorescence index was 5.876, which were better than those of CRP, PCT and CRP alone. The sensitivity of CD64 index, PCT and CRP was 98.21% and specificity of 99.17%. Conclusion The combined detection of CD64, PCT and CRP can improve the sensitivity and specificity of early diagnosis of neonatal sepsis and contribute to the early detection of bacterial infection.