The Value Of CD64and T Lymphocyte Subsets In Neonatal Bacterial Infection

Objective This study aimed to observe the level of neutrophil CD64and Tlymphocyte subset(sCD3、CD4、CD8)in neonatal infection, to assess the clinical valueof neutrophil CD64level for early diagnosis of neonatal infection;this study detectedCD3,CD4,CD8, in order to evaluate cellular immunity in neonatal infection and clearthe relationship between infection and neonatal cellular immune. This study wanted toprovide the basis for the treatment of neonatal bacterial infection.Methods150cases of infected and non-infected newborns were studied,the level ofperipheral blood CD64,CD3,CD4and CD8were measured by flow cytometry,we alsomeasured white blood cell and C-reactive protein,blood culture test were measuredbefore using antibiotics in suspected neonatal septicemia cases,the patients were dividedinto sepsis group, local infection and non-infected group, periphera1sample of neutrophilCD64, CD3,CD4,CD8,C-reactive protein and white blood cell were taken forcomparison; comparison of CD64, CD3,CD4,CD8in sepsis group before and aftertherapy; we compared blood culture and neutrophil CD64in neonatal septicemia group;according to ROC curve, the cut-off value of positive CD64and CRP were calculated.,the area under cure(AUC) of neutrophil CD64, The cut-off of CD64,The sensitivity andspecificity for CD64and that of CRP were taken for comparison during the neonatalinfection,analysis of the relation among neutrophil CD64and T lymphocyte subsets.Thedata were dealt with SPSS11.0,and measurement data were described in (x±S),One wayanalysis of variance(ANOVA), chi square test, paired-samples T test, Pearson correlationanalysis and ROC curve were used for statistical analysis, P values <0.05wasconsidered to be statistically significant. Results1The comparison of CD64, WBC and CRP among the groups of sepsis, the local infection andnon-infectionThe level of neutrophil CD64in sepsis group was (7.0±2.6)%,which wassignificantly higher than that of local infection group(4.0±1.2)%and non-infectiongroup(3.0±0.7)%(P <0.01),the level of neutrophil CD64in local infection group washigher than that of non-infection group(P <0.01);the level of CRP in sepsis group washigher than that of local infection group and non-infection group(P <0.01), the level ofCRP had no difference between local infection group and non-infection group(P>0.05);the level of WBC had no difference in three groups(P>0.05).2The ROC curve of CD64and CRP in diagnosis of neonatal sepsisAccording to the ROC curve,CD64had an AUC of0.94,when the cut-offvalue of positive CD64was determined as3.7,the sensitivity and specificity was90.0%,80.0%for CD64, positive and negative predictive values of CD64was83.9%and91.8%in diagnosing of neonatal sepsis;when the cut-off value of positive CRP wasdetermined as4.6,the sensitivity and specificity was83.3%,54.4%for CRP, positive andnegative predictive values of CRP was50.6%and80.0%, the AUC of CRP.was smallerthan that of CD643The comparison of the positive rate of CD64and blood culture in neonatal sepsisAmong the indices of diagnosing of neonatal sepsis, CD64had the higher positiverate(86.7%)than that of the blood culture test(40.0)%.4.The comparison of T lymphocyte subsets(CD3,CD4,CD8)among the groups ofsepsis, the local infection and non-infectionThe level of CD3、CD4in sepsis group was(46.2±12.4)%(,32.0±10.1)%, whichwas significantly lower than that of local infection groupCD3(61.6±11.3)%,CD4(45.4±10.8)%and non-infection group CD3(62.4±12.0)%,CD4(46.4±12.9)%(P<0.01),the level of CD3、CD4had no difference between local infection group and non- infection group(P>0.05),the level of CD8had no difference in three groups(P>0.05).5. The comparison of CD64, CD3, CD4, CD8in sepsis group before and after therapyAfter therapy,the level of neutrophil CD64was lower than that of sepsis groupbefore therapy(P <0.01), the level of CD3、CD4were higher than that of sepsis groupbefore therapy(P <0.01), the level of CD8had no difference in sepsis group before and aftertherapy(P>0.05).6The relation among CD64and T lymphocyte subsets (CD3,CD4,CD8)The coefficients between CD64and CD3, CD4were-0.533,-0.474(P <0.01)respectively, all were negative correlation; the coefficients between CD64and CD8was-0.159(P>0.05),no liner correlation.Conclusion CD64is a effective marker for the early diagnosis of neonatal infection,which elevated with the aggravation of infection; hypofrontality of T lymphocytesubsets related to neonatal infection,the function of cellular immunity is disorder inneonatal sepsis, combination CD64and T lymphocyte subsets conducted to the earlydiagnose of neonatal infection,prompt treatment and improve the prognosis.