目的 探讨血清淀粉酶A 蛋白(SAA)、中性粒细胞表面抗原CD64 在新生儿败血症诊断及疗效评价中的价值.方法 2011 年5 月至2012 年5 月住院并疑为感染的80 例新生儿,分为败血症组35 例,非败血症感染组45 例;另设对照组20例.检测各组入院时,以及败血症组在治疗1 周后的SAA、CD64 水平,各组间进行比较,并分析SAA、CD64 诊断败血症的敏感性和特异性.结果 败血症组和非败血症感染组CD64、SAA 均明显高于对照组,差异有统计学意义(P<0.01);败血症组CD64 水平高于非败血症感染组,差异亦有统计学意义(P<0.01).败血症组经抗感染治疗1 周后CD64 及SAA 水平均较治疗前下降,差异有统计学意义(P 均<0.01).以CD64 ≥ 2 943 个荧光抗体分子/ 细胞、SAA ≥ 5.3 mg/L、CRP ≥ 8 mg/L为阳性标准,CD64 诊断败血症的敏感性和特异性分别为91.43%、90.00% 均较SAA 及CRP 高.结论 中性粒细胞表面抗原CD64 是早期诊断新生儿败血症的灵敏指标之一.%Objectives To investigate the value of serum amyloid A (SAA) and neutrophils cell surface antigen 64 (CD64) in the early diagnosis of neonatal septicemia. Methods Eighty neonates in a neonatal ward between May 2011 and May 2012 were divided into sepsis group (n=35) and non-septicemic infection group (n=45). Twenty hospitalized neonates with non-infectious diseases were enrolled as controls (n=20). SAA and CD64 were measured upon admission and during the recovery period (1 week post-treatment) and their sensitivity and specificity were analysed. Results The expressions of CD64 and SAA were significantly higher in sepsis group and non-septicemic infection group than those in control group (P<0.01). The expression of CD64 was significantly higher in sepsis group than that in non-septicemic infection group (P<0.01). The expressions of CD64 and SAA were significantly decreased in sepsis group 1 week after treatment as compared to before treatment (P<0.01). When the cutoff values for CD64, SAA and CRP were 2943 molecules/cell, 5.3 mg/L and 8 mg/L, CD64 had higher diagnostic sensitivity and specificity for sepsis (91.43% and 90.00%) than SAA and CRP. Conclusions CD64 is a sensitive indicator for the early diagnosis of neonatal septicemia.
展开▼
