探究外周血中性粒细胞表面CD64对白血病患者细菌感染的诊断效果。

选取2013年1月至2014年1月本院收治的30例白血病合并细菌感染者（A组）、30例白血病非细菌感染者（B组）和30例健康体检志愿者（健康对照组）的临床资料。采用免疫比浊法检测每组患者的C-反应蛋白（CRP）和降钙素原（PCT）水平，采用流式细胞术检测CD4/CD8和CD64的表达，采用电阻抗法检测中性粒细胞百分比（NEU%）。

A组患者的CRP、PCT、NEU%分别为3.27（0.14～4.41）ng/ml、2.4（1.7～3.1）ng/ml和89（80～90）%。B组患者的CRP、PCT、NEU%分别为0.10（0.10～0.10）ng/ml、0.4（0.2～0.6）ng/ml和70（68～75）%。健康对照组的CRP、PCT、NEU%分别为0.06（0.04～0.08）ng/ml、0.2（0.1～0.5）ng/ml和62（50～70）%。健康对照组和白血病非细菌感染组患者的CRP、PCT和NEU%均低于白血病合并细菌感染组患者，其中A组和B组CRP、PCT和NEU%水平差异具有统计学意义（P = 0.024、0.021、0.029，LSD-t = 8.390、8.511、8.153）；A组和C组CRP、PCT和NEU%水平差异具有统计学意义（P = 0.037、0.033、0.039，LSD-t = 7.315、7.672、7.123）。A组患者的CD64指数表达和CD4/CD8指数分别为（95.52±0.31）和（0.64±0.03）；B组患者的CD64指数表达和CD4/CD8分别为（38.33±0.22）和（0.97±0.12）；C组患者的CD64指数表达和CD4/CD8分别为（5.11±0. 43）和（1.64±0.23），健康对照组和白血病非细菌感染组患者的CD64表达均低于白血病合并细菌感染组患者，健康对照组和白血病非细菌感染组患者的CD4/CD8均高于白血病合并细菌感染组患者，差异统计学具有意义（χ²= 2.274、P = 0.035）。PCT的敏感度和特异度分别为67.0%和89.0%，CRP的敏感度和特异度分别为85.0%和76.0%，CD64的敏感度和特异度分别为71.0%和90.0%，NEU%的敏感度和特异度分别为58.0%和86.0%。

CD64诊断白血病合并细菌感染有良好的特异度，对白血病合并细菌感染的早期诊断有重要的诊断价值。

To explore the diagnosis results of peripheral blood neutrophil CD64 on the surface of a bacterial infection in patients with leukemia.

The clinical data of 30 cases of leukemia complicated with bacterial infection (A group), 30 patients with non-bacterial infection of leukemia (B group) and 30 cases of healthy volunteers (healthy control group) were selected in our hospital from January 2013 to January 2014 by immune turbidity detection of patients in each group of C-reactive protein (CRP) and calcitonin peptide (PCT) level by flow cytometry and CD4/CD8 and CD64 expression and the resistance impedance method was applied detect neutrophils (NEU%).

The levels of CRP, PCT and NEU% of patients in A group of were 3.27 (0.14-4.41) ng/ml, 2.4 (1.7-3.1) ng/ml and 89 (80-90)%, respectively. The levels of CRP, PCT and NEU% of patients in B group were were 0.10 (0.10-0.10) ng/ml, 0.4 (0.2-0.6) ng/ml and70 (68-75)%, respectively. The levels of CRP, PCT and NEU% of patients in healthy control group were 0.06 (0.04-0.08) ng/ml, 0.2 (0.1-0.5) ng/ml and 62 (50-70)%, respectively. The levels of CRP, PCT and NEU% in healthy control group and leukemia non-bacterial infection group were all significantly lower than those of patients of leukemia complicated with bacterial infection. The levels of CRP, PCT and NEU% of patients in A group and B group were compared with significant differences (P = 0.024, 0.021, 0.029; LSD-t = 8.390, 8.511, 8.153). The levels of CRP, PCT and NEU% of patients in A group and C group were compared with significant differences (P = 0.037, 0.033, 0.039; LSD-t = 7.315, 7.672, 7.123). The expression of CD64 index and CD4/CD8 index in A group were (95.52±0.31) and (0.64±0.03), respectively; the CD64 index and CD4/CD8 expression in the B group were (38.33±0.22) and (0.97±0.12), respectively; the CD64 index and CD4/CD8 expression in the C group were (5.11±0.43) and (1.64±0.23), healthy control group and patients with non leukemia CD64 expression in bacterial infection group were lower than those of patients with leukemia complicated with bacterial infection group, healthy control group and non leukemia CD4/CD8 in bacterial infection group were significantly higher than that of patients of leukemia complicated with bacterial infection group (χ² = 2.274, P = 0.035). The sensitivity and specificity of PCT detection were 67% and 89%, the sensitivity and specificity of CRP detecting were 85% and 76%, the sensitivity and specificity of CD64 detecting were 71% and 90%, the sensitivity and specificity of NEU% detecting were 58% and 86.0% , respectively.

The diagnosis of leukemia CD64 to bacterial infection was specific for early diagnosis of leukemia with bacterial infection, with important diagnostic value.