CAJ | 학술논문

目的：利用 ROC 曲线探讨中性粒细胞与淋巴细胞比值（NLR）、中性粒细胞 CD64和降钙素原（PCT）在血液细菌感染中的临床价值。方法选取152例确诊为血液细菌感染者作为研究对象（血培养阳性组），102例发热患者除外血液细菌感染者（血培养阴性组）作为对照组。应用流式细胞术检测 CD64、免疫荧光法检测 PCT、全自动五分类细胞分析仪测定中性粒细胞与淋巴细胞，应用受试者工作特征曲线（ROC 曲线）分析3种指标在血液细菌感染中的诊断价值。结果血培养阳性组 NLR、CD64和 PCT 水平明显高于血培养阴性组（P ＜0．01）。ROC 曲线显示，NLR、CD64和 PCT 曲线下面积分别是0．633、0．811和0．868；灵敏度分别是68．7％、73．5％和82．4％；特异度分别是71．8％、66．9％和84．9％。CD64＋PCT、NLR＋PCT、NLR＋CD64联合检测的曲线下面积分别是0．914、0．883、0．844；灵敏度分别是86．8％、85．0％和77．6％；特异度分别是89．8％、86．5％和77．5％；PCT＋CD64＋NLR 联合检测曲线下面积为0．924，灵敏度为91．2％，特异度为90．3％。结论PCT 在血液细菌感染中具有较好诊断价值，PCT＋CD64、PCT＋NLR 联合检测价值优于单项 PCT，而3项联合检测可显著提高其诊断灵敏度和特异度。
목적：이용 ROC 곡선탐토중성립세포여림파세포비치（NLR）、중성립세포 CD64화강개소원（PCT）재혈액세균감염중적림상개치。방법선취152례학진위혈액세균감염자작위연구대상（혈배양양성조），102례발열환자제외혈액세균감염자（혈배양음성조）작위대조조。응용류식세포술검측 CD64、면역형광법검측 PCT、전자동오분류세포분석의측정중성립세포여림파세포，응용수시자공작특정곡선（ROC 곡선）분석3충지표재혈액세균감염중적진단개치。결과혈배양양성조 NLR、CD64화 PCT 수평명현고우혈배양음성조（P ＜0．01）。ROC 곡선현시，NLR、CD64화 PCT 곡선하면적분별시0．633、0．811화0．868；령민도분별시68．7％、73．5％화82．4％；특이도분별시71．8％、66．9％화84．9％。CD64＋PCT、NLR＋PCT、NLR＋CD64연합검측적곡선하면적분별시0．914、0．883、0．844；령민도분별시86．8％、85．0％화77．6％；특이도분별시89．8％、86．5％화77．5％；PCT＋CD64＋NLR 연합검측곡선하면적위0．924，령민도위91．2％，특이도위90．3％。결론PCT 재혈액세균감염중구유교호진단개치，PCT＋CD64、PCT＋NLR 연합검측개치우우단항 PCT，이3항연합검측가현저제고기진단령민도화특이도。
Objective To explore clinical value of NLR (neutrophils-lymphocytes ratio),neutrophil CD64 and pro-calcitonin (PCT)in patientis with blood bacterial infection by ROC.Methods The levels of peripheral blood NLR, CD64 index and serum PCT were determined in 152 cases diagnosed as blood bacterial infection (blood culture-positive group)and 102 patients with fever except blood bacterial infection(blood culture-negative group)by hematology analy-zer,Flow cytometer and immunofluorescence,the diagnosis value of different indicators in the blood bacterial infection were analyzed by ROC.Results NLR,CD64 and PCT levels in blood culture positive group were significantly higher than that in blood culture-negative group(P <0.01).Individual detection NLR,CD64 and PCT,the area under the curve were 0.633,0.811 and 0.868,sensitivity were 68.7%,73.5% and 82.4%,specificity were 71.8%,66.9% and 84.9%respectively;The area under the curve combined detection of CD64+PCT was 0.914,NLR+PCT was 0.883,NLR+CD64 was 0.844,the sensitivity were 86.8%,85.0% and 77.6%,specificity were 89.8%,86.5% and 77.5% respec-tively;Combined detection of PCT+CD64+ NLR,the area under the curve was 0.924,the sensitivity and specificity were 91.2% and 90.3% respectively.Conclusion In the diagnosis of blood bacterial infection,PCT,especially com-bined detection of CD64+PCT,NLR+PCT are sensitive indexes.The sensitivity and specificity can be significantly in-creased with combination of PCT+CD64+NLR.