本文選題：燒傷感染 + CD64��； 參考：《廣西醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：探討外周血中性粒細(xì)胞表面分子CD64的表達(dá)和C-反應(yīng)蛋白(CRP)的變化對燒傷感染患者嚴(yán)重程度的早期診斷及其臨床價(jià)值。 方法：128例燒傷住院患者,分為對照組66例和感染組62例(其中膿毒癥組30例,局部感染組32例)。在入院治療前后分別抽取各組患者外周靜脈血2.5ml,采用流式細(xì)胞儀檢測中性粒細(xì)胞表面分子CD64的表達(dá)水平,同時(shí)檢測外周血CRP、中性粒細(xì)胞的百分比(Neu%)及白細(xì)胞計(jì)數(shù)(WBC)。對其進(jìn)行相關(guān)分析并用Logistic回歸篩選相關(guān)指標(biāo)建立回歸方程,同時(shí)采用ROC曲線對其臨床特性進(jìn)行分析。 結(jié)果：感染組CD64、CRP的表達(dá)顯著高于對照組,差別有統(tǒng)計(jì)學(xué)意義(P0.001)；對感染組(即膿毒癥組+局部感染組)進(jìn)行相關(guān)分析顯示：CD64的表達(dá)與CRP呈正相關(guān)(r=0.455,t=3.961、P0.001)；感染組中膿毒癥組CD64、CRP的表達(dá)水平顯著高于局部感染組,說明兩者的表達(dá)水平與感染的嚴(yán)重程度密切相關(guān),即感染的程度越重,兩者的表達(dá)水平越高；感染組治療后CD64及CRP表達(dá)水平較治療前顯著下降(P0.001),但仍未降到正常水平,與對照組治療前比較差別有統(tǒng)計(jì)學(xué)意義(P0.001)。建立回歸方程Y=-6.891+3.159X1+4.272X2,同時(shí)進(jìn)行ROC曲線分析,新變量Y、CRP、CD64、Neu%和WBC計(jì)數(shù),5種指標(biāo)的敏感性分別為96.80%、91.90%、95.20%、83.90%、85.50%,特異性分別為87.90%、83.30%、81.80%、71.30%、65.20%。 結(jié)論：檢測燒傷感染患者外周血中性粒細(xì)胞表面分子CD64的表達(dá)水平及CRP的變化,可作為早期診斷燒傷感染嚴(yán)重程度的敏感指標(biāo),同時(shí)運(yùn)用Logistic回歸和ROC曲線綜合分析可提高診斷的敏感性和特異性,對燒傷感染患者治療效果的評價(jià)具有重要的臨床意義。
[Abstract]:Objective: to investigate the expression of CD64 on the surface of peripheral blood neutrophils and the changes of C-reactive protein (CRP) in the early diagnosis and clinical value of burn infection. Methods 128 burn inpatients were divided into control group (n = 66) and infection group (n = 62) (sepsis group (n = 30) and local infection group (n = 32). The peripheral venous blood of each group was extracted at 2.5 ml before and after admission. The expression of CD64 on the surface of neutrophils was detected by flow cytometry, the percentage of neuter in peripheral blood and the white blood cell count were also detected. The correlation analysis was carried out and the regression equation was established by Logistic regression, and the clinical characteristics were analyzed by ROC curve. Results: the expression of CD64 CRP in infected group was significantly higher than that in control group. The correlation analysis between infection group (local infection group) showed that there was a positive correlation between CRP and CD64 expression in sepsis group, and the expression level of CD64 in sepsis group was significantly higher than that in local infection group, and the expression of CD64 protein in sepsis group was significantly higher than that in local infection group, and there was a positive correlation between the expression of CD64 and CRP in sepsis group, and the expression of CD64hCRP in sepsis group was significantly higher than that in local infection group. The results showed that the expression level of CD64 and CRP in the infected group was significantly lower than that before treatment, but the expression level of CD64 and CRP in the infected group was not reduced to the normal level, which was closely related to the severity of infection, that is, the higher the degree of infection was, the higher the expression level of both of them was, and the expression level of CD64 and CRP in the infected group decreased significantly after treatment. Compared with the control group before treatment, the difference was statistically significant (P 0.001). The regression equation was established and the ROC curve was analyzed. The sensitivity of the new variable was 96.8091.9091.9091.90 and 83.900.The specificity was 87.9083.300.The specificity was 81.300.71.300.The sensitivity of the new variable was 71.300.The sensitivity was 65.200.The sensitivity of the new variable was 96.800.91.90 and 83.900.The specificity was 87.9083.300.The sensitivity of the new variable was 71.300.The sensitivity of the new variable was 65.20%. Conclusion: detecting the expression of CD64 and the change of CRP in peripheral blood neutrophils of burn infected patients can be used as a sensitive index for the early diagnosis of burn infection severity. At the same time, Logistic regression and ROC curve analysis can improve the sensitivity and specificity of the diagnosis, and it is of great clinical significance to evaluate the therapeutic effect of burn infection patients.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R459.7;R644

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本文編號：1898166