CAJ | 학술논문

目的：分析呼吸道感染患者治疗前后外周血中性粒细胞CD64、血清降钙素原（PCT）、C反应蛋白（CRP）水平的变化。方法入选2012年11月～2013年10月我院收治的80例呼吸道感染患者，经临床诊断42例细菌感染者设为A组，38例病毒感染者设为B组，另外抽选40例健康者设为对照组。对A、B组患者进行常规治疗1周，于治疗前和治疗3 d、7 d时，分别用流式细胞术、免疫荧光分析法、快速免疫荧光法检测CD64、PCT、CRP 的表达变化，对三种方法所做出的结果作对比分析，比较其特异度与敏感度之间的差异。结果治疗前，A组CD64、PCT、CRP水平分别为（2611.5±252.4）MESF、（5.2±2.5） ng/mL、（60.5±13.4） mg/L，均明显高于B 组和对照组（均P＜0.05）；B组的CD64、CRP高于对照组（P＜0.05）；但是PCT与对照组比较，无明显差异（P＞0.05）。治疗7 d后，A组的CD64明显降低，细菌感染程度降低，PCT、CRP也分别降低，与治疗3 d比较差异显著（P＜0.05）；而B组CD64有降低趋势，而PCT、CRP 变化不明显（P＞0.05）。 CD64的灵敏度、特异性、诊断有效率分别为95.6%、92.4%、97.6%，均高于PCT和CRP（P＜0.05）；PCT和CRP间比较差异无统计学意义（P＞0.05）。结论呼吸道感染患者细菌性感染，CD64表达会升高，与呼吸道细菌性感染程度成正相关，特异度与敏感度均比CRP 高，与降钙素原比较不仅能更灵敏的反映疾病情况的严重程度，也能观察疗效，指导临床用药。
목적：분석호흡도감염환자치료전후외주혈중성립세포CD64、혈청강개소원（PCT）、C반응단백（CRP）수평적변화。방법입선2012년11월～2013년10월아원수치적80례호흡도감염환자，경림상진단42례세균감염자설위A조，38례병독감염자설위B조，령외추선40례건강자설위대조조。대A、B조환자진행상규치료1주，우치료전화치료3 d、7 d시，분별용류식세포술、면역형광분석법、쾌속면역형광법검측CD64、PCT、CRP 적표체변화，대삼충방법소주출적결과작대비분석，비교기특이도여민감도지간적차이。결과치료전，A조CD64、PCT、CRP수평분별위（2611.5±252.4）MESF、（5.2±2.5） ng/mL、（60.5±13.4） mg/L，균명현고우B 조화대조조（균P＜0.05）；B조적CD64、CRP고우대조조（P＜0.05）；단시PCT여대조조비교，무명현차이（P＞0.05）。치료7 d후，A조적CD64명현강저，세균감염정도강저，PCT、CRP야분별강저，여치료3 d비교차이현저（P＜0.05）；이B조CD64유강저추세，이PCT、CRP 변화불명현（P＞0.05）。 CD64적령민도、특이성、진단유효솔분별위95.6%、92.4%、97.6%，균고우PCT화CRP（P＜0.05）；PCT화CRP간비교차이무통계학의의（P＞0.05）。결론호흡도감염환자세균성감염，CD64표체회승고，여호흡도세균성감염정도성정상관，특이도여민감도균비CRP 고，여강개소원비교불부능경령민적반영질병정황적엄중정도，야능관찰료효，지도림상용약。
Objective To analyze the changes of CD64, serum procalcitonin and C-reactive protein in the peripheral blood neutrophil of patients with respiratory tract infection before and after treatment. Methods Eighty patients with respiratory tract infection were treated in our hospital from November 2012 to October 2013 , of which 42 cases clini-cally diagnosed by bacterial infection as group A , and 38 cases diagnosed by virus infection as group B ,and 40 healthy people selected as control group. Group A and group B were treated with routine treatment for 1 weeks. CD64 , PCT and CRP expression were detected by the methods of flow cytometry,immunofluorescence assay,and rapid immune fluorescence before and after treatment for 3 days and 7 days ,respectively.The differences of specificity and sensitivity were compared by analyzing the results of three methods. Results Before treatment,CD64, PCT, CRP levels of group A were (2611.5±252.4) MESF,(5.2±2.5) ng/mL, (60.5±13.4) mg/L, respectively, significantly higher than those of group B and control group (P<0.05); CD64 and CRP of group B were higher than those of control group (P<0.05);However, PCT compared with the control group, there was no significant difference (P>0.05). After treatment for 7 days, CD64 of group A decreased significantly, and the degree of bacterial infection decreased,as well as PCT and CRP compared with those after treatment for 3 days (P<0.05),and CD64 of group B showed a decreased trend, while PCT, CRP did not change significantly (P>0.05). The sensitivity,specificity and diagnostic efficiency of CD64 were 95.6%,92.4%,97.6%,respectively,was higher than those of PCT and CRP (P<0.05);But those between PCT and CRP had no significant difference (P>0.05). Conclusion CD64 expression of patients with bacterial infection of respiratory tract infection increased,and positively correlated with the respiratory tract bacterial infection rate,and specificity and sensitivity were higher than those of CRP.When compared with procalcitonin ,CD64 is more sensitive to reflect the severity of disease,and can observe the curative effect and guide clinical medication.