[1]王 璐.中性粒细胞CD64感染指数检测在预测血液病合并细菌性感染预后中的价值[J].陕西医学杂志,2021,50(4):439-442.[doi:DOI:10.3969/j.issn.1000-7377.2021.04.014]
　WANG Lu.Value of neutrophil CD64 infection index in predicting prognosis of patients with hematological diseases and bacterial infections[J].,2021,50(4):439-442.[doi:DOI:10.3969/j.issn.1000-7377.2021.04.014]
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中性粒细胞CD64感染指数检测在预测血液病合并细菌性感染预后中的价值
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年4期
页码:
439-442
栏目:
临床研究
出版日期:
2021-04-05

文章信息/Info

Title:
Value of neutrophil CD64 infection index in predicting prognosis of patients with hematological diseases and bacterial infections
作者:
王 璐
(西安市中心医院血液内科,陕西 西安 710003)
Author(s):
WANG Lu
(Department of Hematology,Xi'an Central Hospital,Xi'an 710003,China)
关键词:
血液病;  细菌性感染;  中性粒细胞;  CD64;  预后
Keywords:
Blood disease;  Bacterial infection;  Neutrophils;  CD64;  Prognosis
分类号:
R 559
DOI:
DOI:10.3969/j.issn.1000-7377.2021.04.014
文献标志码:
A
摘要:
目的:探究中性粒细胞CD64指数(nCD64)在预测血液病合并细菌性感染预后中的应用价值。方法:选择接受治疗的血液病患者203例为对象,统计患者临床资料和确诊感染时的nCD64水平。依据患者感染后30 d内临床结局将患者分为预后良好组和预后不良组。对比分析两组患者基线资料和nCD64。受试者工组特征曲线(ROC)评估感染初期nCD64预测患者不良预后的价值。结果:统计结果显示,33例患者预后不良,预后不良率16.26%。对比分析显示,与良好组相比,预后不良组患者查尔森合并症指数(CCI)、Pitt菌血症评分(PBS)、具有ICU入住史占比和nCD64水平明显升高,合理验证性抗菌治疗占比明显下降(P<0.05)。多因素Logistic回归分析显示,CCI评分、PBS评分和nCD64是影响血液病合并细菌性感染患者预后不良的独立危险因素,合理验证性抗菌治疗是改善患者预后不良的保护性因素(均P<0.05)。ROC曲线分析显示,nCD64预测患者预后不良曲线下面积AUC为0.985(95%CI:0.828～0.962),最佳截断值为5.11,敏感度为78.8%,特异度为87.6%。结论: 血液病合并细菌感染初期血浆nCD64水平是影响患者预后的独立危险因素,在预测患者预后不良方面具有良好灵敏度和特异度。
Abstract:
Objective:To explore the application value of neutrophil CD64 index(nCD64)in predicting the prognosis of patients with hematological diseases and bacterial infections.Methods:A total of 203 patients with hematological diseases were taken as subjects.The clinical data of the patients and the level of nCD64 at the time of diagnosis of infection were collected.According to the clinical outcome within 30 days after infection,patients were divided into good prognosis group and poor prognosis group.The baseline data and nCD64 of the two groups were compared and analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the value of nCD64 in predicting the poor prognosis of patients at the initial stage of infection.Results:The statistical results showed that 33 patients had a poor prognosis,with a poor prognosis rate of 16.26%.Comparative analysis showed that compared with the good prognosis group,the patients in poor prognosis group had significantly higher CCI,PBS,the proportion of patients with ICU admission history and nCD64 level,while the proportion of patients with reasonable confirmatory antimicrobial therapy decreased significantly(all P<0.05).Multivariate logistic regression analysis showed that CCI score,PBS score and nCD64 were independent risk factors for poor prognosis of patients with hematological diseases and bacterial infections,and reasonable confirmatory antimicrobial therapy was protective factor for improving the poor prognosis of patients(all P<0.05).ROC curve analysis showed that the area under the curve of nCD64 in predicting poor prognosis was 0.985(95%CI:0.828-0.962),the best cut-off value was 5.11,the sensitivity was 78.8%,and the specificity was 87.6%.Conclusion:Plasma nCD64 level is an independent risk factor for the prognosis of patients with hematological diseases and bacterial bloodstream infection,which has good sensitivity and specificity in predicting poor prognosis.

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备注/Memo

备注/Memo:
基金项目:陕西省中医药科技发展计划项目(2016-130)
更新日期/Last Update: 2021-04-06