摘要
目的探讨急性胰腺炎（AP）患者中性粒细胞CD64（n CD64）水平与病变程度的关系。方法收集2015年1-5月南京大学医学院附属金陵医院住院的AP患者样本65例,根据急性生理和慢性健康评估评分（APACHEⅡ）、Ranson评分和CT分级等分为重度急性胰腺炎组（SAP,n=45）和轻度急性胰腺炎组（MAP,n=20）;以30例健康体检者为健康对照组。用流式细胞术分别检测n CD64、C反应蛋白（CRP）和IL-6水平;受试者工作特征曲线（ROC）评估n CD64对AP和SAP的诊断效能;采用单因素相关分析和多元线性回归分析n CD64与CRP、IL-6、APACHEⅡ评分的关系。结果 SAP组和MAP组n CD64水平均较健康对照组明显升高（P均〈0.01）,且SAP组高于MAP组（P〈0.01）;n CD64鉴别AP和健康对照者的曲线下面积（AUCROC）为0.944（95%CI：0.901-0.987,P〈0.01）,鉴别SAP和MAP的AUCROC为0.925（95%CI：0.855-0.995,P〈0.01）,均优于APACHEⅡ评分、CRP和IL-6。AP患者n CD64水平分别与APACHEⅡ评分（r=0.382,P=0.002）、CRP（r=0.656,P〈0.01）和IL-6（r=0.265,P=0.036）呈正相关。多元线性回归分析显示n CD64决定了14.3%APACHEⅡ评分的变化（β=0.398,P=0.002;r2=0.143）;CRP决定了40.7%n CD64水平（β=0.638,P=0.000;r2=0.407）。结论 AP患者n CD64水平明显升高,并与AP的严重程度相关,是潜在的AP病情评估的有效指标。
Objective To explore the association between neutrophil CD64（ n CD64） level and the severity of acute pancreatitis（ AP）.Methods All samples were collected from 65 hospitalized patients in Jinling Hospital from January 2015 to May 2015,and divided into the groups of severe acute pancreatitis（ SAP,n = 45） and mild acute pancreatitis（ MAP,n = 20） according to the evaluation standard,including the scores of APACHEⅡ,Ranson and computed tomography severity index. Thirty healthy volunteers were used as controls. The differences of serum n CD64,C-reactive protein（ CRP） and interleukin-6（ IL-6） level among the groups of SAP,MAP and control were analyzed. Receiver operating characteristic（ ROC） curve were analyzed to assess the performance of n CD64 in AP or SAP diagnosis. The associations of n CD64 with CRP,IL-6 and APACHEⅡscores were analyzed by correlations and stepwise multiple linear regression. Results Compared with control,n CD64 levels were significantly increased in both SAP and MAP patients（ P〈0. 01）. The n CD64 level was higher in SAP group than that in MAP group（ P〈0. 01）. The areas under ROC curve（ AUCROC） of n CD64 for predicting AP and SAP were 0. 944（ 95% CI： 0. 901-0. 987,P〈0. 01） and 0. 925（ 95% CI： 0. 855-0. 995,P〈0. 01）,respectively,which was superior to those of APACHE Ⅱ score,CRP and IL-6 levels. The n CD64 levels of all AP patients were positively correlated with APACHEⅡ score（ r = 0. 382,P = 0. 002）,CRP levels（ r = 0. 656,P〈0. 01） and IL-6 levels（ r = 0. 265,P = 0. 036）. The multiple linear regression analysis showed that n CD64（ β = 0. 398,P = 0. 002） accounted for 14. 3% of the variation in APACHEⅡscore（ r2=0. 143）,and CRP（ β = 0. 638,P = 0. 000） accounted for 40. 7% of the variation in n CD64（ r2= 0. 407）. Conclusion n CD64 level was significantly increased in AP patients. Elevated n CD64 level was associated with the severity of AP. The n CD64 should be potentially useful indicator for assessment of AP disease condition.
出处
《临床检验杂志》
CAS
CSCD
2015年第9期673-677,共5页
Chinese Journal of Clinical Laboratory Science
基金
国家自然科学基金(81271904)
检验医学国家临床重点专科
