Chen Qiqi, Shi Junfeng, Fei Aihua, Wang Feilong, Pan Shuming, Wang Weiwei
Department of Emergency, Xinhua Hospital, Shanghai Jiaotong University Medical College Shanghai, China.
Department of Clinical Laboratory, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine Shanghai 200092, China.
Int J Clin Exp Pathol. 2014 Oct 15;7(11):7806-13. eCollection 2014.
Neutrophil CD64 has been shown to be a promising biomarker for bacterial infection and sepsis identification. However, the prognostic value of CD64 in predicting the likelihood of survival for patients in intensive care unit (ICU) is unclear.
A total of 797 patients in the ICU of Xin-Hua Hospital, Shanghai, China were enrolled. We determined the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores from these patients and collected blood samples to measure the levels of neutrophil CD64, thyroid hormone and C-reactive protein (CRP). We assessed the association between APACHE II scores or these biomarkers and mortality of patients in the ICU. Receiver operating characteristic (ROC) curves were generated and the Area Under the Curve (AUC) for each indicator was determined.
The AUC for CD64 was 0.752 ± 0.026, which was higher than that of FT3 (0.696 ± 0.028) and CRP (0.672 ± 0.026). APACHE II scores had the highest AUC (0.872 ± 0.018). The level of neutrophil CD64 expression positively associated with CRP and APACHE II, and negatively correlated with FT3. Multiple regression analysis revealed that APACHE II scores (Standard β value = 0.183, P < 0.001), CD64 (Standard β value = 0.518, P < 0.001) or log (CRP) (Standard β value = 1.203, P < 0.001) independently predicted ICU mortality.
CD64 had the greatest power for predicting ICU mortality other than APACHE II scores. This result indicates that CD64 may be used as a biomarker to in combination with the use of APACHE II scores to improve the accuracy of predicting mortality outcome for patients in the ICU.
中性粒细胞CD64已被证明是用于细菌感染和脓毒症识别的一种很有前景的生物标志物。然而，CD64在预测重症监护病房（ICU）患者生存可能性方面的预后价值尚不清楚。
纳入了中国上海新华医院ICU的797例患者。我们确定了这些患者的急性生理与慢性健康状况评分系统II（APACHE II）评分，并采集血样以检测中性粒细胞CD64、甲状腺激素和C反应蛋白（CRP）水平。我们评估了APACHE II评分或这些生物标志物与ICU患者死亡率之间的关联。绘制了受试者工作特征（ROC）曲线，并确定了每个指标的曲线下面积（AUC）。
CD64的AUC为0.752±0.026，高于游离三碘甲状腺原氨酸（FT3）（0.696±0.028）和CRP（0.672±0.026）。APACHE II评分的AUC最高（0.872±0.018）。中性粒细胞CD64表达水平与CRP和APACHE II呈正相关，与FT3呈负相关。多元回归分析显示，APACHE II评分（标准β值=0.183，P<0.001）、CD64（标准β值=0.518，P<0.001）或log（CRP）（标准β值=1.203，P<0.001）可独立预测ICU死亡率。
除APACHE II评分外，CD64在预测ICU死亡率方面具有最大效能。该结果表明，CD64可作为一种生物标志物，与APACHE II评分联合使用，以提高预测ICU患者死亡结局的准确性。
