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Objective:To investigate serum C-reactive protein (CRP) , procalcitonin (PCT) and neutrophil CD64 in predicting early infection after internal fixation of limb fractures.Methods:A total of 2 572 patients with limb fractures undergoing internal fixation in Taishun County People’s Hospital from January 2016 to December 2022 were enrolled. Postoperative infection occurred in 121 cases (infected group) and did not occur in 2 451 cases (uninfected group). Serum levels of PCT, CRP and CD64 were tested at admission and d1, d3, d5 and d7 after operation. Repeated measurement analysis of variance was used to compare the serum levels of PCT, CRP and CD64 at different time points between two groups, the receiver operating characteristic curve (ROC) was used to evaluate the predictive value of each index or in combination for early infection after internal fixation of limbs fractures.Results:The early infection rate after internal fixation was 4.70% (121/2 572). The levels of PCT, CRP and CD64 in the infection group began to rise after operation and decreased on d7; there were significant differences in PCT, CRP and CD64 levels between the two groups on d3, d5 and d7 after operation (PCT: Ftime=678.607, Fintergroup=2 218.323, Finteraction=653.150; CRP: Ftime=392.724, Fintergroup=1 812.502, FInteraction =379.577; CD64: Ftime=373.686, Fintergroup=4 817.438, Finteraction=528.353, all P< 0.001) . The area under the ROC curve of combined detection of PCT, CPR, and CD64 for predicting early infection was 0.856; the sensitivity and specificity of combined detection were 69.2% and 94.7%, respectively. The combined detection of three indicators showed better prediction values than PCT, CRP and CD64 alone ( Z=6.176, 3.838 and 2.431, P<0.01 or <0.05), and also better than combined detection of PCT and CRP ( Z=2.875, P=0.019). Conclusions:The combined detection of CD64, PCT and CRP is of value in prediction of postoperative infection after internal fixation of limb fractures, which is worthy of clinical application.
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Objective:To investigate the diagnostic value of neutrophil CD64 index (nCD64) in disseminated nontuberculous mycobacteria (NTM) infection.Methods:Thirty-six patients with NTM infection from January 2020 to June 2021 in Huashan Hospital, Fudan University were included. Patients were classified into groups of disseminated infection and focal infection according to their medical history and discharge diagnosis. The expressions of nCD64 in patients with focal infection and disseminated infection before treatment were collected and analyzed. Statistical analysis was performed using the Mann-Whitney U test, and the diagnostic value of nCD64 for disseminated NTM infection was analyzed using the receiver operator characteristic curve (ROC curve). Results:Among the 36 patients with NTM infection, 18 cases were focal infection (due to the low white blood cell count of the patient with myelodysplastic syndrome, the detection results were biased, which were excluded from the subsequent analysis) and 18 cases were disseminated infection. The expression of nCD64 in focal infection was 0.72(0.50, 1.55), and that in disseminated infection was 13.63(6.77, 32.31). The difference was statistically significant ( U=15.50, P<0.001). Using focal infection as a control, the area under the ROC curve for the operational characteristics of the subjects was 0.949 3 for disseminated NTM infection. The diagnostic cut-off value of nCD64 was 3.06, with the sensitivity and specificity of the disseminated NTM infection were 88.89% and 100.00%, respectively. Conclusions:In patients with NTM infection before effective treatment, the diagnostic cut-off value of nCD64 of 3.06 has high sensitivity and specificity, which is useful for the aided diagnosis of disseminated NTM infection.
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Objective:To investigate the level and significance of CD64 index, matrix metalloproteinase-9 (MMP-9) and serum amyloid A (SAA) in peripheral blood of patients with severe carbapenem resistant Enterobacteriaceae (CRE) infection.Methods:A total of 61 patients with severe CRE infection who were admitted to the neurosurgery department of Kashgar First People′s Hospital from January 2019 to January 2022 were selected as the CRE group, and 100 patients with severe carbapenem sensitive Enterobacteriaceae (CSE) infection were selected as the CSE group. The difference in clinical data between the two groups was compared, and the difference in clinical data between the dead and surviving patients in the CRE group was compared. The value of CD64 index, MMP-9 and SAA in differential diagnosis of CRE was analyzed. Logistic regression was used to analyze the influencing factors of prognosis in patients with CRE infection.Results:The age, hypertension, lung disease, liver and kidney disease, comorbidities≥2, antibiotic use≥2 combinations, antibiotic use time>10 days, proportion of carbapenem use, CD64 index, MMP-9, and SAA of the CRE group patients were significantly higher than those of the CSE group patients (all P<0.05). The area under the receiver operating characteristic (ROC) curve for CD64 index, MMP-9, and SAA differential diagnosis of CRE was 0.857, 0.701, and 0.655, respectively (all P<0.05). In the CRE group, the age , the score of Acute Physiological and Chronic Health Status Ⅱ (APACHE Ⅱ) score at admission, diabetes, liver and kidney diseases, comorbidities≥2, the proportion of carbapenems, CD64 index, MMP-9 and SAA of dead patients were significantly higher than those of survivors (all P<0.05). Logistic regression analysis showed that age, APACHE Ⅱ score at admission, comorbidities≥2, CD64 index, MMP-9, and SAA were influencing factors for the prognosis of severe CRE patients (all P<0.05). Conclusions:The peripheral blood CD64 index, MMP-9, and SAA have certain application value in the diagnosis of neurological severe CRE infection, and are also influencing factors for the prognosis of CRE infected patients.
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Objective:To investigate the diagnostic value of neutrophil CD64 index in sepsis patients in intensive care unit (ICU).Methods:A prospective case-control study was conducted, the patients admitted to ICU of Jiangbei People's Hospital Affiliated to Nantong University from December 2016 to June 2020 were enrolled. According to the criteria of Sepsis 3, 107 patients diagnosed with sepsis were classified as the sepsis group, 112 patients without infection were classified as control group. Peripheral venous blood samples were collected within 24 hours after ICU admission, neutrophil CD64 index, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC) were detected. Receiver operating characteristic curve (ROC curve) was used to evaluate the diagnostic value of neutrophil CD64 index, CRP, PCT and WBC for sepsis.Results:The neutrophil CD64 index, CRP and PCT in sepsis group were significantly higher than those in control group [neutrophil CD64 index: 9.03±5.59 vs. 3.18±1.50, CRP (mg/L): 146.9±68.3 vs. 46.5±35.8, PCT (ng/L): 31.82±14.71 vs. 1.87±1.42, all P < 0.05]. ROC curve analysis showed that neutrophil CD64 index, CRP and PCT had certain diagnostic value for sepsis, the area under ROC curve (AUC) were 0.924, 0.915 and 0.879, respectively, the 95% confidence intervals (95% CI) were 0.871-0.978, 0.855-0.975, 0.807-0.951, respectively, P values were 0.016, 0.017 and 0.026, respectively. Among the three indicators, the diagnostic value of neutrophil CD64 index was much higher. When the optimal cut-off value was 4.32, the sensitivity and specificity were 83.6% and 88.7%, respectively, which were higher than the sensitivity (75.1%, 76.3%) and specificity (87.2%, 82.5%) of CRP and PCT. Conclusion:Neutrophil CD64 index is a valuable biomarker for the diagnosis of sepsis in ICU.
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Objective To explore the clinical diagnostic value of CD64 index of neutrophil and serum amy-loid A(SAA)in early bacterial infections of children with respiratory tract.Methods A total of 152 children with respiratory tract infection admitted to Xianning Central Hospital from January 2017 to December 2017 were retrospectively analyzed.According to whether the pathogens were isolated,they were divided into 84 ca-ses of bacterial infection group and 68 cases of suspected respiratory tract infection group,at the same time,50 cases of healthy children in the same period were selected as the control group,the level of CD64 and SAA in three groups of patients was compared and analyzed,and the sensitivity,specificity,positive predictive value and negative predictive value of CD64 and SAA for the diagnosis of bacterial infection were also analyzed.Re-sults The CD64 index and SAA level in the bacterial infection group were higher than those of the suspected respiratory infection group(P< 0.05),after effective treatment,the two were significantly decreased(P<0.05).T he sensitivity,specificity,positive predictive value and negative predictive value of CD 64 index in diag-nosing bacterial infection were 92.9%,98.0%,98.7% and 89.1%,respectively,SAA was 96.4%,96.0%, 97.6% and 94.1%,respectively.Conclusion The detection of CD64 index and SAA level can help the early diagnosis,differential diagnosis and prognosis evaluation of respiratory tract bacterial infection in children, which is worthy of clinical promotion.
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Objective To observe the correlation between CD64 index levels in peripheral blood and the severity and prognosis factors of postoperative traumatic sepsis,and investigate the clinical effect of these changes in the development of postoperative traumatic sepsis.Methods A total of 560 patients with trauma were enrolled in the study,and these patients were divided into the postoperative traumatic sepsis group (210 cases) and the postoperative general trauma group (350 cases) according to clinical manifestations.According to the severity of the postoperative traumatic sepsis,these patients were divided into low-risk group (64 cases),moderate-risk group (75 cases) and high-risk group (71 cases).According to clinical prognosis,these patients with post-traumatic sepsis were divided into survival group (178 cases) and death group (32 cases).The CD64 index in peripheral blood and APACHE Ⅱ score were analyzed and measured by flow cytometry.The differences and correlation between CD64 index levels and APACHE Ⅱ score were compared and analyzed,and the relationship between CD64 index levels and the severity and prognosis of postoperative traumatic sepsis were also assessed.Results The CD64 index levels of postoperative traumatic sepsis group were higher than the postoperative general trauma group (P<0.05).The differences in terms of CD64 index,APACHE Ⅱ score and mortality rate among low-risk group,moderate-risk group and high-risk group were statistically significant,in which high-risk group was the highest,followed by moderate-risk group,and low-risk group was the lowest(P<0.05).Compared with the survival group,the death group had higher CD64 index levels and APACHE Ⅱ score (P<0.05).The CD64 index levels were positive correlated with APACHE Ⅱ score (r=0.72,P=0.00) and mortality (r=0.56,P=0.00).ROC curves analysis results showed that the area under curve of CD64 index was 0.874 (95%CI:0.765~0.896), and the optimal operating point was 7.08,which had 82.6% sensiticity and 86.4% specificity.Conclusion The increased CD64 index levels in postoperative traumatic sepsis are closely related to the severity and prognosis of disease,and the CD64 index levels can be effective predictor with some clinical application value.
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Objective To investigate the expression and early diagnosis value of CD64 index levels in peripheral blood cells in patients with postoperative traumatic sepsis.Methods A number of 420 trauma patients were enrolled in the study,and they were divided into the postoperative traumatic sepsis group(130 cases)and postoperative general trauma group(290 cases)according to the clinical manifestations. The CD64 levels in peripheral blood were measured by flow cytometry,and the levels of C-reactive protein(CRP)and white blood cell count (WBC)were detected.The diagnostic value of these indexes on postoperative traumatic sepsis were evaluated.Results The CD64 index, CRP and WBC levels in postoperative traumatic sepsis group were significantly higher than postoperative general trauma group(P 0.05).The ROC curve analysis showed that when CD64 index(7.21)considered as the boundary for early diagnosis of postoperative traumatic sepsis,the sensitivity and spe-cificity of diagnosis for postoperative traumatic sepsis were 85.1% and 87.8%,the area under the ROC curve(AUC)was 0.865(95%CI 0.784 ~0.929),which was significantly better than CRP index.Conclusion The expression of CD64 is higher in patients with postoperative traumatic sepsis,which can be used as an effective indicator for early diagnosis of postoperative traumatic sepsis,and it has an important clin-ical application value.
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Objective:To investigate the early diagnosis value of neutrophilic CD 64 index(nCD64 ID),neutrophilic CD32 index( nCD32 ID) in ascites and CRP in blood of liver cirrhosis patients combined with spontaneous bacterial peritonitis. Methods:The data of 156 cases with liver cirrhosis was analyzed retrospectively, which CD32 index, CD64 index and CRP were detected respectively and ROC curve analysis were performed. Results:The nCD64 ID,nCD32 ID and CRP in bacterial infection group were all significantly higher than that in no infection group(P<0. 001). The sensitivity and specificity of nCD32 ID,nCD64 ID and CRP were 82. 8%,96. 2%,72. 5% and 81. 0%, 95. 8%, 73. 1% respectively. Conclusion: The sensitivity and specificity of nCD64 ID were higher than nCD32 ID and CRP. The nCD64 ID can be used as an effective index for early diagnosis and differential diagnosis of liver cirrhosis combined with spontaneous bacterial peritonitis.
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Objective To investigate the prognostic value of CD 4+CD25+/high CD127 low/-and CD14+HLA-DRlow/-for evaluating the severity of acute pancreatitis .Methods The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index were measured by flow cytometry in pa-tients with acute pancreatitis ( including 43 cases of mild acute pancreatitis and 24 cases of severe acute pan-creatitis).Moreover, the levels of C-reactive protein (CRP), acute physiology and chronic health evaluationⅡ( APACHEⅡ) score and CT severity index ( CTSI ) were detected for a correlation analysis .Results The percentages of CD4+CD25+/highCD127low/-and CD14+HLA-DRlow/-and the CD64 index in patients with severe and mild acute pancreatitis were significantly higher than those in healthy subjects .Patients with se-vere acute pancreatitis showed higher percentages of CD 14+HLA-DRlow/-than patients with mild acute pan-creatitis.With the disease progression, the CD64 index and the levels of CD4+CD25+/highCD127low/-, CD14+HLA-DRlow/-and CRP were significantly dropped after an initial increase in patients with mild acute pancrea -titis, while these indexes were continuously elevated in patients with severe acute pancreatitis .The percent-age of CD14+HLA-DRlow/-was positively correlated with CD64 index, CRP level, APACHEⅡ score and CTSI.Conclusion CD14+HLA-DRlow/-level was closely related to the severity of acute pancreatitis , which could be used as immune parameter for the estimation of the clinical severity of acute pancreatitis .
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Objective To detect the ascites CD64 index of patients with decompensated cirrhosis ,and explore the value in the di-agnosis of spontaneous bacterial peritonitis (SBP) .Methods Decompensated cirrhosis with ascites patients were divided into non-SBP group ,SBP suspected group and SBP diagnosed group .Two control groups were composed of patients with ascites culture pos-itive and non-SPB group .SBP suspected group were further grouped according to abdominal pain and the percentage of peripheral blood neutrophils .The CD64 index was detected by flow cytometry .Compared the difference of ascites CD64 index after treatment , and analyzed diagnosis performance of procalcitonin in human peripheral blood and ascites white blood cell count of SBP .Results The level of the ascites CD64 index was significantly higher in SBP diagnosed group (179 .39 ± 65 .56)and SBP suspected group (115 .49 ± 58 .42)than that of non-SBP group(26 .88 ± 26 .05)(P0 .05) .The level of the ascites CD64 index in SBP suspected with percentage of peripheral blood neutrophils elevated group was increased significantly than non-elevated group(P<0 .05) .CD64 index level in effective treatment group was significantly lower than the ineffective treatment group(P<0 .01) .The area of the ascites CD64 index under the curve was greater than procalcitonin in human peripheral blood and ascites WBC count ,and had a higher sensitivity and specificity .Conclusion The detection process of the ascites CD64 index is fast and with less influential factors ,which provides a new choice for the clinical diagnosis of SBP .
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Objective To evaluate the values of CD64 expression in diagnosis of infected patients referred to intensive care unit.Method Sixty febrile children referred to the hospital intensive care unit from 2009.11 to 2010.03 were enrolled for a retrospective study.Fever was defined as a body temperature reaching 38℃ or higher with specifically bacterial infection or highly suspected with bacterial infection or viral infection.There were 28 patients with bacterial infection and 32 with viral infection.The non-infectious diseases such as juvenile rheumatoid arthritis and Kawasaki disease were excluded.The controls were 50 healthy children asking for physical examination.On admission,CD64 were measured by using flow cytometry,and blood routine examination,ESR,PCT,blood cultures and sputum cultures were simultaneously detected in all febrile patients.Data were statistically analyzed by using SAS 16.0 software.Data are given as means±SE.Categorical variables were analyzed using X2 test and continuous variables were compared by applying paired 1-tailed t test,Significance level was set at less than 0.05.Results of them,57.1%bacterial infection patients and 71.9%viral infection patients contracted pneumonia.CD64 in bacterial infection patients、viral infection patients and the subjects of control group were(12.6±9.7),(5.4±2.42)and (2.9±0.77),respectively.The CD64 in the bacterial infection patients were significantly higher than those in the virus infection patients(F=11.002,P=0.004).Conclusions CD64 in infected children referred to a hospital intensive care unit can be clearly distinguished between bacterial infections and viral infections, providing an important guidance and a flexible strategy for clinical treatment and determine the timing of withdrawal.