Peripheral neutrophil CD64 index combined with complement, CRP, WBC count and B cells improves the ability of diagnosing bacterial infection in SLE
Peripheral neutrophil CD64 index combined with complement, CRP, WBC count and B cells improves the ability of diagnosing bacterial infection in SLE
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DOI：
10.1177/0961203319827646
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发表时间：
2019-03-01
期刊：
影响因子：
2.6
通讯作者：
Luo, J.
中科院分区：
文献类型：
--
作者：
Feng, M.;Zhang, S. L.;Luo, J.
目的探讨补体C3、补体C4、C反应蛋白（CRP）、降钙素原（PCT）、白色细胞计数（WBC）、中性粒细胞CD 64（nCD 64）指数、淋巴细胞亚群及其组合在鉴别系统性红斑狼疮细菌感染与疾病复发中的作用方法回顾性分析36例合并细菌感染的SLE患者和45例未合并细菌感染的SLE发作患者的上述生物标志物。细菌感染的诊断依据为细菌培养阳性或典型的临床症状和体征，并对抗生素有阳性反应。狼疮复发定义为比之前的SLE疾病活动指数评分高3分。通过受试者工作特征曲线下面积（AUC）和一种结合多种生物标志物的新型生物评分系统来评估细菌感染的诊断价值。（p=0.049），WBC在感染组中观察到C3（p = 0.001）、C4（p = 0.016）和B细胞水平（p=0.010）显著降低。上述6种生物标志物的AUC无显著差异。有趣的是，nCD 64指数、CRP、WBC、C3和C4的组合显著提高了SLE感染的诊断潜力（AUC 0.783（四分位距0.672，0.871），p
Objective To investigate the diagnostic role of complement C3, complement C4, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), neutrophil CD64 (nCD64) index, lymphocyte subsets and their combination in differentiating bacterial infection from disease relapse in systemic lupus erythematosus (SLE).Methods The above biomarkers in 36 hospitalized SLE patients with bacterial infection and 45 with lupus flare without infection were retrospectively studied. Bacterial infection was proven by positive cultures or typical clinical symptoms and signs combined with positive response to antibiotics. Lupus flare was defined as three points greater than their previous SLE disease activity index score. The diagnostic value for bacterial infection was evaluated by the areas under the receiver operating characteristic curves (AUC) and a novel bioscore system combining multiple biomarkers.Results Increased CRP (p=0.049), WBC (p=0.028) and nCD64 index (p=0.034) were observed in the infected group and C3 (p=0.001), C4 (p=0.016) and B cells levels (p=0.010) were significantly reduced. The AUC for the above six biomarkers had no significant difference. Interestingly, the combination of nCD64 index, CRP, WBC, C3 and C4 improved significantly the diagnostic potential of SLE infection (AUC 0.783 (interquartile range 0.672, 0.871), p