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中性粒细胞CD64在急诊科诊断脓毒症中的作用。

Effect of neutrophil CD64 for diagnosing sepsis in emergency department.

作者信息

Yin Wen-Peng, Li Jia-Bao, Zheng Xiao-Fang, An Le, Shao Huan, Li Chun-Sheng

机构信息

Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.

出版信息

World J Emerg Med. 2020;11(2):79-86. doi: 10.5847/wjem.j.1920-8642.2020.02.003.

Abstract

BACKGROUND

The aim of this study is to investigate the diagnostic and prognostic value of neutrophil CD64 (nCD64) as a novel biomarker in sepsis patients.

METHODS

One hundred fifty-one adult patients diagnosed with sepsis and 20 age-matched healthy controls were enrolled in the study. Patients with sepsis were further subdivided into a sepsis group and a septic shock group. nCD64 expression, serum procalcitonin (PCT) level, C-reactive protein (CRP) level, and white blood cell (WBC) count were obtained for each patient, and Sequential Organ Failure Assessment (SOFA) scores were calculated.

RESULTS

nCD64 expression was higher in the sepsis group with confirmed infection than in the control group. The receiver operating characteristic (ROC) curve of nCD64 was higher than those of SOFA score, PCT, CRP and WBC for diagnosing infection. The area under the curve (AUC) of nCD64 combined with SOFA score was the highest for all parameters. The AUC of nCD64 for predicting 28-day mortality in sepsis was significantly higher than those of PCT, CRP, and WBC, but slightly lower than that of SOFA score. The AUC of nCD64 or PCT combined with SOFA score was significantly higher than that of any single parameter for predicting 28-day mortality.

CONCLUSION

nCD64 expression and SOFA score are valuable parameters for early diagnosis of infection and prognostic evaluation of sepsis patients.

摘要

背景

本研究旨在探讨中性粒细胞CD64(nCD64)作为脓毒症患者一种新型生物标志物的诊断和预后价值。

方法

151例诊断为脓毒症的成年患者和20例年龄匹配的健康对照者纳入本研究。脓毒症患者进一步分为脓毒症组和感染性休克组。获取每位患者的nCD64表达、血清降钙素原(PCT)水平、C反应蛋白(CRP)水平和白细胞(WBC)计数,并计算序贯器官衰竭评估(SOFA)评分。

结果

确诊感染的脓毒症组nCD64表达高于对照组。nCD64的受试者工作特征(ROC)曲线在诊断感染方面高于SOFA评分、PCT、CRP和WBC的ROC曲线。nCD64与SOFA评分联合的曲线下面积(AUC)在所有参数中最高。nCD64预测脓毒症患者28天死亡率的AUC显著高于PCT、CRP和WBC,但略低于SOFA评分。nCD64或PCT与SOFA评分联合预测28天死亡率的AUC显著高于任何单一参数。

结论

nCD64表达和SOFA评分是脓毒症患者感染早期诊断和预后评估的有价值参数。

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