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目的 观察新生儿败血症中性粒细胞粘附分子CD11b表达的规律 ,并评价其在新生儿败血症早期诊断中的价值。方法 将 5 1例临床疑似败血症的新生儿根据其临床表现及WBC、PLT、血浆CRP和未成熟中性粒细胞数与中性粒细胞总数比值 (I/T)四项指标 ,分为败血症和可疑败血症两组。采用全血流式细胞术检测患儿和 15例正常对照组新生儿中性粒细胞CD11b的平均荧光强度 (MFI)。结果 败血症组 2 3例 ,可疑败血症组 2 8例。两组中性粒细胞CD11b分别为 (32 0± 189)、(4 5 6± 2 13)MFI,均显著低于正常对照组的 (10 90± 338)MFI(t分别为 - 9 0 1、- 7 5 6 ,P均 <0 0 0 1) ,败血症组又低于可疑败血症组 ,差异有显著性 (t=- 2 39,P <0 0 5 )。高CRP组患儿CD11b为 (2 11± 16 4 )MFI,低于低CRP组的 (5 0 5± 2 6 5 )MFI,差异有显著性 (t=2 6 4 ,P <0 0 5 )。中性粒细胞CD11b≤ 6 0 0MFI对疑似败血症新生儿诊断的敏感性、特异性、阳性和阴性预测值分别为 86 3%、10 0 %、10 0 %、6 8 2 % ,CD11b检测阳性率为 86 3% ,高于血培养的阳性率 (17 6 % ) ,差异有显著性 (χ2 m=31 2 ,P <0 0 5 )。结论 新生儿败血症中性粒细胞粘附分子CD11b表达下调 ,其下调与感染严重程度有一定关系。中性粒细胞CD11b的动态检测对早期?
Objective To observe the expression of neutrophil adhesion molecule CD11b in neonatal sepsis and evaluate its value in the early diagnosis of neonatal sepsis. Methods Fifty-one neonates with suspected clinical sepsis were divided into four groups according to their clinical manifestations and the four indicators of WBC, PLT, plasma CRP, immature neutrophil count and total neutrophil count (I / T) Suspected sepsis two groups. The mean fluorescence intensity (MFI) of neonatal neutrophils CD11b in children and 15 normal controls was measured by whole blood flow cytometry. Results 23 cases of sepsis group, 28 cases of suspected sepsis group. The neutrophil CD11b of the two groups were (32 0 ± 189) and (456 ± 2 13) MFI, respectively, which were significantly lower than those of the control group (10 90 ± 338) MFI (-901, - 7 5 6, all P <0 0 01), and sepsis group was lower than the suspicious sepsis group, the difference was significant (t = -239, P <0 05). CD11b was (2 11 ± 16 4) MFI in high CRP group, which was lower than that in low CRP group (50 ± 2 6 5) MFI (t = 2 64, P 0 05) . The sensitivity, specificity, positive predictive value and negative predictive value of neutrophil CD11b ≤ 600 MFI were 86 3%, 100%, 100% and 682% respectively in the diagnosis of suspected neonatal septicemia. The positive rate of CD11b (86.3%), which was higher than that of blood culture (17.6%) (χ2m = 31 2, P <0 05). Conclusion The expression of neutrophil adhesion molecule CD11b in neonatal sepsis is down-regulated, which is related to the severity of infection. Neutrophil CD11b dynamic detection of early?