摘要
目的 探讨全血中性粒细胞CD64联合单核细胞趋化蛋白1（monocyte chemotactic protein 1,MCP-1）、白细胞介素8（interleukin-8,IL-8）及γ干扰素诱导蛋白10（interferon-inducible protein-10,IP-10）检测在新生儿败血症临床诊断中的价值.方法 选择2015年3月至2016年6月福州市第一医院儿科收治的新生儿败血症患儿为败血症组,同期选择非感染性疾病新生儿35例为非感染组及健康新生儿40例为健康对照组.通过流式细胞仪检测各组新生儿全血CD64,应用酶联免疫反应检测血清MCP-1、IL-8和IP-10含量,单因素ANOVA法比较组间差异.绘制全血CD64、血清MCP-1、IL-8及IP-10诊断败血症的受试者工作特征曲线.结果 败血症组（70例）血CD64、IL-8及IP-10含量高于非感染组（35例）和健康对照组（40例）,差异有统计学意义（P＜0.05）;败血症组MCP-1含量高于健康对照组[（61.6＋13.6） ng/L比（39.6＋20.4）ng/L],差异有统计学意义（P＜0.05）,但与非感染组差异无统计学意义（P＞0.05）;非感染组血MCP-1和IP-10含量明显高于健康对照组,差异有统计学意义（P＜0.05）,但CD64和IL-8含量与健康对照组相比差异无统计学意义（P＞0.05）.血CD64、MCP-1、IL-8及IP-10诊断败血症的最佳临界值分别为35.0 MFI、58.6 ng/L、60.3 ng/L、0.46 μg/L;4项指标单独诊断败血症的敏感度和特异度分别为：CD64 92.8％、90.6％,MCP-1 70.0％、42.6％,IL-8 78.5％、68.0％,IP-10 72.8％、54.6％;联合检测的敏感度和特异度分别为97.1％和94.6％.结论 全血中性粒细胞CD64、血清MCP-1、IL-8及IP-10联合检测可提高新生儿败血症诊断的敏感度和特异度.
Objective To investigate the value of neutrophil CD64 combined with monocyte chemotactic protein 1 （MCP-1）,interleukin-8 （IL-8） and interferon-inducible protein-10 （IP-10） in the clinical diagnosis of neonatal sepsis.Method Cases of neonatal sepsis from March 2015 to June 2016 in the department were chosen as sepsis group.35 neonates with non-infection diseases were selected as noninfection group and 40 healthy newborn infants were assigned as control group.The level of CD64 in blood were detected by flow cytometry,while the level of MCP-1,IL-8 and IP-10 of the serum in the three groups were detected by automatic biochemical analyzer.The differences between groups were compared by single factor ANOVA.The ROC curves of sepsis diagnosed by whole blood CD64,serum MCP-1,IL-8 and IP-10 were drew.Result The level of CD64,IL-8 and IP-10 of the neonatal blood in the sepsis group were significantly higher than that in the non-infection group （P 〈 0.05） and control group （P 〈 0.05）.There were no significant difference between the sepsis group and non-infection group in MCP-1 （P 〉 0.05）,but significantly higher than that in the control group （P 〈 0.05）.The levels of serum MCP-1 and IP-10 in the non-infection group were significantly higher than those in the control group （P 〈 0.05）,but there was no significant difference between the non-infection group and control group in CD64 and IL-8 （P 〉0.05）.The optimal thresholds of blood CD64,MCP-1,IL-8 and IP-10 in the diagnosis of sepsis were 35.0 MFI,58.6 ng/L,60.3 ng/L,0.46 μg/L.The sensitivity and specificity of the diagnosis of sepsis were 92.8% and 90.6% in CD64,70.0% and 42.6% in MCP-1,78.5% and 68.0% in IL-8,72.8% and 54.6% in IP-10,97.1% and 94.6% when combined.Conclusion The combination test of CD64,MCP-1,IL-8 and IP-10 can improve the sensitivity and specificity of the diagnosis of sepsis.
基金
福建省自然科学基金资助项目（2015J01496）
