CAJ | 학술논문

目的评估CD64指数在重症监护室感染患儿中的临床意义和诊断价值.方法本研究采用疾病/对照方法进行回顾性分析,2009年11月至2010年3月重症监护室住院的发热患儿共60例人选疾病组.发热定义为体表温度≥38℃,其中明确或高度怀疑为细菌感染的28例,明确为病毒感染者32例,幼儿型风湿病、川崎病等非感染性患儿剔除本研究;对照组为外科患儿或健康体检儿童共50例.所有患儿均在入选后第1天进行CD64流式测定,疾病组患儿还同步进行血常规、血沉、降钙素原、血培养和痰培养等的检测.统计分析使用SAS 16.0软件,计量资料以均数±标准差(x±s)表示,分类变量应用x2检验,连续变量比较使用配对单侧t检验,以P<0.05表示差异有统计学意义.结果两组中均以肺炎最为常见,分别为57.1%和71.9%.细菌感染组、病毒感染组和对照组的CD64指数分别为(12.6±9.7)、(5.4±2.42)和(2.9±0.77),表明细菌组和病毒组相对于对照组而言,CD64指数均出现增高,而细菌组的增高明显高于病毒组,两组间差异具有统计学意义(F=11.002,P=0.004).结论重症炼护室感染患儿中CD64的检测可有助于区分细菌和病毒感染,为临床用药治疗和判断停药时机提供可行的策略和重要依据.
목적 평고CD64지수재중증감호실감염환인중적림상의의화진단개치.방법 본연구채용질병/대조방법진행회고성분석,2009년11월지2010년3월중증감호실주원적발열환인공60례인선질병조.발열정의위체표온도≥38℃,기중명학혹고도부의위세균감염적28례,명학위병독감염자32례,유인형풍습병、천기병등비감염성환인척제본연구;대조조위외과환인혹건강체검인동공50례.소유환인균재입선후제1천진행CD64류식측정,질병조환인환동보진행혈상규、혈침、강개소원、혈배양화담배양등적검측.통계분석사용SAS 16.0연건,계량자료이균수±표준차(x±s)표시,분류변량응용x2검험,련속변량비교사용배대단측t검험,이P<0.05표시차이유통계학의의.결과 량조중균이폐염최위상견,분별위57.1%화71.9%.세균감염조、병독감염조화대조조적CD64지수분별위(12.6±9.7)、(5.4±2.42)화(2.9±0.77),표명세균조화병독조상대우대조조이언,CD64지수균출현증고,이세균조적증고명현고우병독조,량조간차이구유통계학의의(F=11.002,P=0.004).결론 중증련호실감염환인중CD64적검측가유조우구분세균화병독감염,위림상용약치료화판단정약시궤제공가행적책략화중요의거.
Objective To evaluate the values of CD64 expression in diagnosis of infected patients referred to intensive care unit.Method Sixty febrile children referred to the hospital intensive care unit from 2009.11 to 2010.03 were enrolled for a retrospective study.Fever was defined as a body temperature reaching 38℃ or higher with specifically bacterial infection or highly suspected with bacterial infection or viral infection.There were 28 patients with bacterial infection and 32 with viral infection.The non-infectious diseases such as juvenile rheumatoid arthritis and Kawasaki disease were excluded.The controls were 50 healthy children asking for physical examination.On admission,CD64 were measured by using flow cytometry,and blood routine examination,ESR,PCT,blood cultures and sputum cultures were simultaneously detected in all febrile patients.Data were statistically analyzed by using SAS 16.0 software.Data are given as means±SE.Categorical variables were analyzed using X2 test and continuous variables were compared by applying paired 1-tailed t test,Significance level was set at less than 0.05.Results of them,57.1%bacterial infection patients and 71.9%viral infection patients contracted pneumonia.CD64 in bacterial infection patients、viral infection patients and the subjects of control group were(12.6±9.7),(5.4±2.42)and (2.9±0.77),respectively.The CD64 in the bacterial infection patients were significantly higher than those in the virus infection patients(F=11.002,P=0.004).Conclusions CD64 in infected children referred to a hospital intensive care unit can be clearly distinguished between bacterial infections and viral infections, providing an important guidance and a flexible strategy for clinical treatment and determine the timing of withdrawal.