摘要
目的研究中性粒细胞CD64指数、PCT及CRP对烧伤患者感染的临床诊断价值。方法选择2018年8月-2019年3月在台州恩泽医疗中心集团浙江省台州医院收治的117例疑似烧伤感染患者作为研究对象。按感染情况分为未感染组(61例)、感染组(39例)及脓毒症组(17例),40例同期健康体检者为对照组。检测患者CD64指数、PCT及CRP等感染指标,比较各组患者感染指标表达水平,革兰阳性菌和革兰阴性菌感染者的各项指标水平,绘制ROC曲线比较各指标诊断烧伤感染及脓毒症的效能。结果 3组烧伤患者各项指标均显著高于健康对照组(均P<0.05);感染组CD64指数、CD64阳性率和PCT显著高于未感染组(均P<0.05);脓毒症组各指标均显著高于感染组(均P<0.05)。革兰阴性菌感染者PCT显著高于革兰阳性菌感染者(P<0.05)。CD64指数对烧伤感染诊断效能最优,诊断烧伤感染的敏感度为82.14%(46/56)、特异度为88.52%(54/61)、约登指数为0.707;诊断脓毒症CD64指数约登指数(0.780)最大,而PCT的AUC(0.896)最高。CD64指数和PCT联合诊断感染和脓毒症时,敏感度和约登指数均高于单项指标。结论 CD64指数联合PCT诊断烧伤感染和脓毒症敏感性和特异性较好,具有良好的临床应用前景。
Objective To study the diagnostic value of CD64 index of neutrophils, PCT and CRP in burn patients. Methods Total 117 patients with suspected burn infection admitted to our hospital from August 2018 to March 2019 were selected as the study subjects. According to the infection situation, the patients were divided into uninfected group(61 cases), infection group(39 cases) and sepsis group(17 cases). Another 40 healthy people in the same period were selected as control group. CD64 index, CD64 positive rate, PCT and CRP were detected. The expression levels of infection indicators in each group were compared. The indicators of gram-positive bacteria and gram-negative bacteria were compared. The ROC curve was drawn to compare the efficacy of infection indicators in diagnosis of burn infection and sepsis. Results The indicators of burn patients of the three groups were significantly higher than those in the control group(all P<0.05). The CD64 index, CD64 positive rate and PCT in the infected group were significantly higher than those in the uninfected group(all P<0.05). The indicators in the sepsis group were significantly higher than those in the infected group(all P<0.05). PCT of gram-negative bacterial infections was significantly higher than that of gram-positive bacterial infections(P<0.05). CD64 index has the best diagnostic efficiency for burn infection, with sensitivity 82.14%(46/56), specificity 88.52%(54/61) and Yoden index 0.707. Yoden index of CD64 index for sepsis(0.780) is the largest, and the AUC(0.896) for PCT is the highest. When CD64 index and PCT were combined to diagnose infection and sepsis, the sensitivity and Yoden index were higher than those of single index. Conclusion CD64 index combined with PCT has good sensitivity and specificity in the diagnosis of burn infection and sepsis, and has good clinical application prospects.
作者
廖米荣
屠巍巍
蔡立真
LIAO Mi-rong;TU Wei-wei;CAI Li-zhen Burn(Department of Enze Hospital of Taizhou Enze Medical Center Group,Taizhou,Zhejiang 317000,China)
出处
《中华全科医学》
2020年第6期950-953,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2018KY892)。
