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目的探讨中性粒细胞CD64指数在慢性阻塞性肺疾病急性加重期(AECOPD)细菌感染中的诊断价值。方法收集慢性阻塞性肺疾病(COPD)患者50例,其中COPD稳定期组10例、AECOPD非细菌感染组16例和AECOPD细菌感染组24例。所有COPD患者均进行白细胞计数(WBC)、血沉(ESR)、C反应蛋白(CRP)、降钙素原(PCT)和中性粒细胞CD64指数等检查,并比较其在3组之间的差异。绘制受试者工作特征(ROC)曲线,采用Z检验比较曲线下面积(AUC),确定诊断最佳截取值。结果 WBC、ESR、CRP、PCT和中性粒细胞CD64指数在3组之间差异有统计学意义。绘制WBC、ESR、CRP、PCT和中性粒细胞CD64指数诊断AECOPD细菌感染的ROC曲线,其AUC分别为0.779、0.750、0.772、0.885、0.929。中性粒细胞CD64指数的AUC显著高于WBC、ESR和CRP,差异有统计学意义(P<0.05);高于PCT,但二者差异无统计学意义(P>0.05)。中性粒细胞CD64指数以2.35为截取值,诊断灵敏度和特异度为87.5%和84.6%。结论中性粒细胞CD64指数作为炎症性生物标记物,可用于AECOPD细菌感染的诊断。
Objective To investigate the diagnostic value of neutrophil CD64 index in bacterial infection of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Fifty patients with chronic obstructive pulmonary disease (COPD) were collected, including 10 patients with stable COPD, 16 with AECOPD non-bacterial infection and 24 with AECOPD bacterial infection. All patients with COPD were examined for WBC, ESR, CRP, PCT and neutrophil CD64 index, and their differences among the three groups were compared . The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was compared using the Z test to determine the best diagnostic cutoff. Results The WBC, ESR, CRP, PCT and neutrophil CD64 index in the three groups showed statistically significant differences. The ROC curves of WBC, ESR, CRP, PCT and neutrophil CD64 index in diagnosis of AECOPD bacterial infection were drawn. The AUCs of AEC were 0.779,0.750,0.772,0.885,0.929 respectively. The AUC of neutrophil CD64 index was significantly higher than WBC, ESR and CRP, the difference was statistically significant (P <0.05); higher than PCT, but the difference was not statistically significant (P> 0.05). The neutrophil CD64 index was cut off at 2.35, with diagnostic sensitivity and specificity of 87.5% and 84.6%. Conclusion Neutrophil CD64 index as an inflammatory biomarker can be used for the diagnosis of AECOPD bacterial infection.