摘要
目的：探索外周血白细胞表达的 CD64水平结合脂蛋白 A[LP(a)]、C 反应蛋白（CRP）、中性粒细胞碱性磷酸酶（NAP）积分3种指标对鉴别发热是否诊断为细菌感染的意义。方法对发热患者进行分组﹐在治疗前均进行外周血病原学培养（或根据病情需要同时取骨髓病原学培养）﹐并取其外周血用流式细胞术检测白细胞表达的 CD64水平﹐同时检测 LP(a)、CRP、NAP 积分。对于病原学培养阳性的52例患者﹐收集其上述指标的结果﹐综合分析观察细菌感染的患者上述指标的变化情况。结果细菌感染引起的发热将导致 CD64、LP(a)、CRP、NAP 积分明显升高﹐部分非感染因素引起的发热病例 CRP、NAP积分可能升高﹐但 CD64及 LP(a)均无明显升高。结论 CD64可作为鉴别细菌性感染及其他非感染性发热的参考指标﹐结合 LP(a)、CRP、NAP 积分等其他指标将有助于对发热的原因进行分析。
Abstract
Objective To explore the utility of CD64 level in combination with apolipoprotein A, C-reactive protein (CRP), neutrophil alkaline phosphatase (NAP) score in identifying bacterial infection in febrile patients. Methods Febrile patients were allotted to different groups. Peripheral blood samples were collected to culture the potential pathogens before treatment (or bone marrow culture of bacterial pathogens if necessary). CD64 level expressed on leukocytes from peripheral blood samples were detected by flow cytometry. Serum apolipoprotein A, CRP, and NAP levels were determined simultaneously. The changing pattern of these markers were analyzed for 52 patients with positive bacterial blood stream infections. Results The fever caused by bacterial infection led to significantly increased levels of CD64, apolipoprotein A, CRP, and NAP score. Some febrile patients due to other non-infectious causes showed increase of CRP and NAP levels, but not CD64 and apolipoprotein A. Conclusions CD64 may be one of the markers for differentiating the fever due to bacterial infection from other non-infectious fever. It works better if combined with apolipoprotein A, CRP and NAP score.
NETL
NSTL
维普
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