外周血单核细胞HLA-DR/CD14分析的临床意义及其与降钙素原、C-反应蛋白、白细胞计数的相关性

目的:探讨外周血单核细胞HLA-DR/CD14表达在感染性疾病中的临床意义,及其与降钙素原(PCT)、C-反应蛋白(CRP)、白细胞(WBC)计数等指标的相关性。方法:收集2012-01~2013-07住院患者75例,包括脓毒血症患者47例,其中重度感染患者25例设为观察1组、中度感染患者22例设为观察2组;非感染炎症患者10例,设为观察3组;其他疾病患者18例,设为观察4组;以及本院健康体检者21例,设为正常对照组。用流式细胞术分析外周血单核细胞HLA-DR/CD14,同步定量检测各组的PCT、CRP、WBC指标,用SPSS13.0软件对各组间数据进行方差分析及相关性比较。结果:观察1、2组各项指标与正常对照组间均存在显著性差异,1、2组间除WBC外其他各项指标间均存在显著性差异,3、4组与1、2组比较各项指标均存在显著性差异,P值均0.01;观察1、2组内HLA-DR/CD14与PCT、CRP存在显著负相关关系,而与WBC不存在显著性相关关系。结论:HLA-DR/CD14在感染性疾病中具有重要意义,联合检测HLA-DR/CD14和PCT、CRP、WBC,有助于感染性疾病的临床评估、诊断治疗及疗效观察。

Clinical Application of HLA-DR/CD14 of Peripheral Blood Mononuclear Cells and its Correlation with PCT,CRP and WBC

Objective： To approach the clinical value of HLA-DR/CD14 of peripheral blood mononuclear cells in infectious diseases and its correlation with proealeitonin（PCT）, C reactive protein（CRP） and white blood cells （WBC）. Methods： 75 hospitalized patients were collected from Jan, 2012 to July, 2013, including 47 sepsis patients（25 high-degree infectious patients as group 1, 22 midrange infectious patients as group 2）, 10 non-infectious inflammation patients as group 3, 18 another diseases patients as group 4, and 21 healthy people as normal control group. HLA-DR/CD14 was detected with flow cytometry, and PCT, CRP and WBC were detected at equal pace. Using SPSS13.0 to analyze the results with ANOVA and compare the correlation. Results： Compared with normal control group, there were significant differences in all indexes among group 1, 2 and normal control group. There were significant differences in all indexes except WBC between group 1 and group 2. Compared with group 1 and 2, there were significant differences in all indexes among group 3, 4 and group 1, 2. Compared with HLA- DR/CD14, there were negatively significant correlation among HLA-DR/CD14, PCT and CRP, there were no significant correlation between HLA-DR/CD14 and WBC, both in group 1 and 2. Conclusion： HLA-DR/CD14 plays an important role in diagnosis of the infectious diseases. Combining detection HLA-DR/CD14 with PCT, CRP and WBC could conduce to the infectious disease evaluation, dignosis and treatment, and therapeutic effect observation.