单核细胞HLA-DR表达及中性粒细胞CD64表达作为危重新生儿和婴儿感染生物标志物的研究
Monocyte HLA-DR expression and neutrophil CD64 expression as biomarkers of infection in critically ill neonates and infants.
作者信息
Juskewitch Justin E, Abraham Roshini S, League Stacy C, Jenkins Sarah M, Smith Carin Y, Enders Felicity T, Grebe Stefan K, Carey William A, Huskins W Charles
机构信息
Mayo Graduate School, Mayo Clinic, Rochester, Minnesota.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
出版信息
Pediatr Res. 2015 Dec;78(6):683-90. doi: 10.1038/pr.2015.164. Epub 2015 Aug 31.
BACKGROUND
Reduced monocyte HLA-DR expression and increased neutrophil CD64 expression have been proposed as biomarkers of infection.
METHODS
From 2009-2011, blood samples from neonatal intensive care unit (NICU) and pediatric intensive care unit (ICU) patients <1 y of age were collected at enrollment and during subsequent evaluation for suspected infection, if it occurred. Samples were analyzed for monocyte HLA-DR and neutrophil CD64 expression levels by flow cytometry.
RESULTS
Forty-seven infants had study samples collected at enrollment; 26 infants had study samples collected at the time of a suspected infection. At enrollment, there was an inverse relationship between neutrophil CD64 expression and age (P ≤ 0.047). At the time of suspected infection, infants with an infection demonstrated a lower percentage of HLA-DR+ monocytes (P = 0.02, area under the curve (AUC) 0.78), higher percentage of CD64+ neutrophils (P = 0.009, AUC 0.81), and higher neutrophil CD64 expression levels (P = 0.04, AUC 0.75).
CONCLUSION
Monocyte HLA-DR and neutrophil CD64 expression in critically ill infants are related to age and infection.
背景
单核细胞人类白细胞抗原-DR（HLA-DR）表达降低和中性粒细胞CD64表达增加已被提出作为感染的生物标志物。
方法
2009年至2011年期间，收集了新生儿重症监护病房（NICU）和儿科重症监护病房（ICU）中年龄小于1岁的患者在入组时以及随后疑似感染（若发生）评估期间的血样。通过流式细胞术分析样本中的单核细胞HLA-DR和中性粒细胞CD64表达水平。
结果
47名婴儿在入组时采集了研究样本；26名婴儿在疑似感染时采集了研究样本。入组时，中性粒细胞CD64表达与年龄呈负相关（P≤0.047）。在疑似感染时，感染婴儿的HLA-DR+单核细胞百分比更低（P = 0.02，曲线下面积（AUC）0.78），CD64+中性粒细胞百分比更高（P = 0.009，AUC 0.81），中性粒细胞CD64表达水平更高（P = 0.04，AUC 0.75）。
结论
危重症婴儿的单核细胞HLA-DR和中性粒细胞CD64表达与年龄和感染有关。
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