目的探讨中性粒细胞CD64(neutrophils CD64,nCD64)指数、C反应蛋白(C reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)和降钙素原(procalcitonin,PCT)水平对病毒性和细菌性上呼吸道感染的诊断价值。方法选取2023年1月至2024年1月浙江中医药大学附属杭州市西溪医院诊治的上呼吸道感染患者为研究对象,根据病原学检查结果将其分为细菌感染组(46例)和病毒感染组(58例)。比较两组患者用药前nCD64指数、CRP、IL-6和PCT水平。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估感染标志物对细菌性、病毒性上呼吸道感染的鉴别诊断价值。结果细菌感染组患者的CRP、nCD64指数、IL-6、PCT水平均显著高于病毒感染组(P<0.01)。ROC曲线结果显示,nCD64指数、CRP、PCT、IL-6鉴别两种感染类型的曲线下面积(area under the curve,AUC)分别为0.818、0.776、0.692、0.654,四者联合的AUC为0.870(95%CI:0.796~0.943)。结论nCD64指数、CRP、IL-6和PCT均与上呼吸道感染患者病原类型关系密切,各指标联合检测可提高对上呼吸道感染类型的诊断效能。
目的 研究hiv/aids合并早期隐性梅毒患者外周血t淋巴细胞及其激活亚群的变化,探讨其临床意义.方法 用流式细胞仪检测78例hiv/aids患者、66例hiwaids合并早期隐性梅毒患者和30名健康体检者的t淋巴细胞及其激活亚群( hla-dr+ cd3 +/cd3+、hla-dr+cd4 +/cd4+和hla-dr+ cd8 +/cd8+),同时行梅毒快速血浆反应素试验(rpr)和梅毒螺旋体明胶凝集试验(tppa)检测.采用spss 13.0软件进行统计分析,两样本均数的比较采用t检验(正态分布)或mann-whitney u检验(偏态分布).结果 hiv/aids合并梅毒患者cd4+t淋巴细胞计数显著高于hiv/aids组(t=2.041和2.223,p值均＜0.05),但在cd3+t和cd8 +t淋巴细胞计数方面差异无统计学意义(tcd3 =0.362和0.692,tcd8=0.043和0.617,p值均＞0.05).aids合并梅毒组hla-dr+cd4+/cd4+显著高于hiv合并梅毒组(t=2.647,p＜0.05),但在hla-dr+ cd3 +/cd3+和hla-dr+cd8 +/cd8+方面两组比较差异无统计学意义(t=1.112和0.093,p值均＞0.05).结论 hiv/aids患者感染隐性梅毒早期细胞免疫功能存在一过性增强的可能.
abstract：
objective to investigate the expression of t lymphocytes and activated subsets in patients with hiv/aids and early latent syphilis. methods t lymphocytes and activated subsets ( hladr+ cd3 +/cd3 + , hla-dr+ cd4 +/cd4 + and hla-dr+ cd8 +/cd8 + ) as well as rapid plasma reagin (rpr) and treponema pallidum particle agglutination (tppa) test were detected by flow cytometry in 78 patients with hiv/aids, 66 patients with hiv/aids and early latent syphilis, and 30 healthy subjects. spss 13.0 was used for statistical analysis, and t (for normal distribution) or mann-whitney u (for skew distribution) tests were performed to compare between the groups. results the absolute counts of cd4+ t cells in patients with hiv/aids and early latent syphilis were significantly higher than those in hiv/aids patients ( t = 2. 041 and 2. 223, p ＜ 0.05 ), but no difference in the counts of cd3 + t cells and cd8 + t cells was observed (tcd3 =0. 362
