中国全科医学2018，Vol.21Issue(12)：1442-1445,1450,5.DOI:10.3969/j.issn.1007-9572.2017.00.194
CD64指数联合中性粒细胞绝对值对极低出生体质量儿脓毒血症及坏死性小肠结肠炎的诊断价值研究
Diagnostic Value of CD64Index Combined with Absolute Neutrophil Count for Pyemia and Necrotizing Enterocolitis in Infants with Very Low Birth Weight
摘要
Abstract
Objective To discuss the diagnostic value of CD64index combined with absolute neutrophil count(ANC) for pyemia and necrotizing enterocolitis(NEC) in infants with very low birth weight(VLBW).Methods We enrolled 30 infants with VLBW who received treatment in the NICU of the First People's Hospital of Yunnan Province from September 1,2016 to March 1,2017 and measured their CD64index and ANC.Logistic regression analysis was conducted to produce new variables for diagnosing pyemia(ps) and NEC(pN),respectively.ROC curve was used to analyze the diagnostic value of CD64index, ANC and ps for pyemia,CD64index,ANC and pN for NEC.Results The average level of CD64index was(1.57±0.92), and that of ANC was(1.87±0.82) ×109/L for the infants.ROC curve analysis of CD64index,ANC and ps for the diagnosis of pyemia:the AUC of CD64index was 0.878[95%CI(0.707,0.968),P<0.001] with a sensitivity of 87.5%,specificity of 86.4% and accuracy of 86.7%.When the critical value of CD64index was 2.00,its corresponding Youden index reached the maximum.The AUC of ANC was 0.849[95%CI(0.672,0.953),P<0.001] with a sensitivity of 75.0%,specificity of 86.4% and accuracy of 83.3%.When the critical value of ANC was 1.17×109/L,its corresponding Youden index reached the maximum.The AUC of ps was 0.943[95%CI(0.793,0.995),P<0.001] with a sensitivity of 100.0%,specificity of 86.4%and accuracy of 90.0%.When the critical value of ps was 0.219 7,its Youden index reached the maximum.ROC curve analysis of CD64index,ANC and pN for the diagnosis of NEC:the AUC of CD64index was 0.968[95%CI(0.830,0.999),P<0.001] with a sensitivity of 100.0%,specificity of 80.0% and accuracy of 83.3%.When the critical value of CD64index was 2.00, its corresponding Youden index reached the maximum.The AUC of ANC was 0.720[95%CI(0.527,0.868),P=0.045] with a sensitivity of 40.0%,specificity of 100.0% and accuracy of 93.3%.When the critical value of ANC was 0.95×109/L,its corresponding Youden index reached the maximum.The AUC of pN was 0.984[95%CI(0.856,0.999),P<0.001] with a sensitivity of 100.0%,specificity of 96.0% and accuracy of 96.7%.When the critical value of pN was 0.240 1,its corresponding Youden index reached the maximum.ANC and pN had higher specificity for NEC diagnosis than CD64index(P<0.05). Conclusion CD64index combined with ANC owns high sensitivity and specificity for the diagnosis of neonatal pyemia,which can be used as an important diagnostic index for neonatal pyemia.CD64index combined with ANC owns high sensitivity for the diagnosis of NEC,but diagnostic specificity of CD64index combined with ANC for NEC is higher than that of CD64index alone.关键词
脓毒症/小肠结肠炎,坏死性/婴儿,极低出生体重/CD64指数Key words
Pyemia/Enterocolitis/necrotizing/Infant/very low birth weight/CD64index分类
医药卫生引用本文复制引用
何山,李利,米弘瑛,杨景晖..CD64指数联合中性粒细胞绝对值对极低出生体质量儿脓毒血症及坏死性小肠结肠炎的诊断价值研究[J].中国全科医学,2018,21(12):1442-1445,1450,5.基金项目
云南省科技计划项目(2017FE467-122 （）
2016NS237) （）
