CD64鎰熸煋鎸囨暟妫€娴嬭瘯鍓傜洅(娴佸紡缁嗚優浠硶)
--涓€х矑缁嗚優CD64鎰熸煋鎸囨暟--鏂板瀷鎰熸煋鏍囧織鐗?/h3>
鏍锋湰绫诲瀷锛欵DTA鎶楀嚌鍏ㄨ
鏍″噯鍝侊細璇锋牴鎹墍鐢ㄦ祦寮忕粏鑳炰华鍨嬪彿閫夌敤鍘傚瑕佹眰閰嶅鐨勬牎鍑嗗搧
璐ㄦ帶鍝侊細璇锋牴鎹墍鐢ㄦ祦寮忕粏鑳炰华鍨嬪彿閫夌敤鍘傚鎺ㄨ崘鐨勮川鎺у搧
閰嶅浠櫒锛氫腑鐢烞ioCyte銆丗lowCyte/ZS-AE7S銆丗ACSCantoII銆丗ACSCalibur銆丏xFLEX銆丯avios銆丯ovoCyte銆丅riCyte E6绛夋祦寮忕粏鑳炰华
鎸囨爣绠€浠婞/h3>
CD64涓昏琛ㄨ揪浜庡法鍣粏鑳炪€佸崟鏍哥粏鑳炲強鏍戠獊鐘剁粏鑳炵瓑鎶楀師閫掑憟缁嗚優 (APC)琛ㄩ潰銆傛甯告儏鍐典笅锛屼腑鎬х矑缁嗚優CD64琛ㄩ潰鍛堜綆姘村钩琛ㄨ揪锛屼絾褰撴満浣撴劅鏌撴垨鍐呮瘨绱犲叆渚垫椂锛屽ぇ閲忚嚧鐐庣粏鑳炲洜瀛愰噴鏀撅紝姣斿鑴傚绯栵紙lipopolysaccharide锛孡PS)銆佺矑缁嗚優闆嗚惤鍒烘縺鍥犲瓙锛坓ranulocytecolony stimulating factor锛孏-CSF)銆?gamma;-骞叉壈绱狅紙interferon-γ锛孖FN-γ)绛夛紝涓€х矑缁嗚優CD64鍦ㄤ笂杩拌嚧鐐庡洜瀛愬埡婵€涓嬪ぇ閲忚〃杈撅紝涓€鑸湪鍒烘縺鍥犲瓙鍒烘縺鍚?~6h鍗冲彲鍗囬珮[1, 2]锛屽ぇ閲忚〃杈剧殑CD64涓庡叾閰嶄綋缁撳悎鍚庯紝鍚姩骞舵斁澶у厤鐤弽搴旓紝涓昏鍙備笌鎶椾綋渚濊禆缁嗚優浠嬪鐨勭粏鑳炴瘨浣滅敤銆佺粏鑳炲悶鍣綔鐢ㄣ€佹竻闄ゅ厤鐤鍚堢墿浣滅敤绛夈€傝€屽崟鏍哥粏鑳炲拰娣嬪反缁嗚優琛ㄩ潰CD64鐨勮〃杈惧湪鑴傚绯栧埡婵€鍚庡彉鍖栦笉澶с€傚洜姝わ紝涓€х矑缁嗚優CD64 (neutrophil CD64锛宯CD64) 琛ㄨ揪琚涓烘槸鍙嶆槧澶氱鐐庣棁鎯呭喌涓嬬殑鎰熸煋鐘舵€併€傜洰鍓嶄复搴婂簲鐢ㄨ緝澶氱殑鎰熸煋鐐庣棁鎸囨爣鐗瑰紓鎬с€佹晱鎰熸€у潎鏈変笉瓒筹紝鍥犳闇€瑕佺爺绌舵柊鐨勬劅鏌撴€ф爣蹇楃墿锛屾彁楂樻劅鏌撴€х柧鐥呮棭鏈熻瘖鏂殑鍑嗙‘鎬э紝鎸囧鍚堢悊鐨勬姉鎰熸煋娌荤枟锛岄檷浣庣梾姝荤巼锛屾敼鍠勬偅鑰呴鍚庯紝鍑忓皯鎶楃敓绱犺€愯嵂銆傝繎骞存潵锛屼腑鎬х矑缁嗚優CD64鏄爺绌舵瘮杈冨鐨勬柊鍨嬫劅鏌撴爣蹇楃墿涔嬩竴銆傛湁鐮旂┒琛ㄦ槑锛屼笌浼犵粺鎰熸煋鎸囨爣濡傚鍛ㄨ鐧界粏鑳 (WBC) 璁℃暟銆丆鍙嶅簲铔嬬櫧 (CRP) 鍜岄檷閽欑礌鍘 (PCT) 绛夌浉姣旓紝涓€х矑缁嗚優CD64鍦ㄦ晱鎰熸€с€佺壒寮傛€ф柟闈㈠叿鏈夌嫭鐗逛紭鍔匡紝骞朵笖妫€娴嬫柟娉曠畝渚垮揩鎹凤紝鍦ㄦ劅鏌撹瘖鏂€佺枟鏁堣瘎浼般€侀鍚庡垽鏂瓑鏂归潰鍏锋湁骞挎硾鐨勪复搴婂簲鐢ㄥ墠鏅?span style="color:hsl(212,80%,42%);">[3]銆傚洜鍗曟牳缁嗚優琛ㄩ潰CD64琛ㄨ揪楂樹笖绋冲畾锛屽彲浣滀负nCD64鎸囨暟鐨勯槼鎬у鐓э紱鑰屾穻宸寸粏鑳炶〃闈㈠嚑涔庝笉琛ㄨ揪CD64锛屽皢鍏朵綔涓洪槾鎬у鐓э紝nCD64鎸囨暟鐨勭粨鏋滃憟鐜版柟寮忚€冭檻鍒颁釜浣撲箣闂寸殑鍐呭弬鍥犵礌锛宯CD64鎸囨暟鍥犲叾绋冲畾鎬у強鍑嗙‘鎬ф洿楂樿€岃鏇村箍娉涗娇鐢?span style="color:hsl(212,80%,42%);">[4]銆侟/p>
妫€娴嬪師鐞咟/h3>
娴佸紡缁嗚優浠硶锛氬緟娴嬫牱鏈殑缁嗚優鎮恫锛屽湪闉樻恫鐨勫寘鍥村拰绾︽潫涓嬶紝缁嗚優鎺掓垚鍗曞垪楂橀€熺敱娴佸姩瀹ゅ柗鍢村柗鍑猴紝褰㈡垚缁嗚優娑叉煴銆傚綋娑叉煴閫氳繃妫€娴嬪尯锛屽湪鍏ュ皠鐨勬縺鍏夋潫鐓у皠涓嬩骇鐢熷墠鍚戣鏁ｅ皠鍏夛紙FSC锛夊拰渚у悜瑙掓暎灏勫厜锛圫SC锛夛紝瀹冧滑鍒嗗埆鍙嶆槧缁嗚優澶у皬鍜岄绮掑害锛屾牴鎹繖浜涚壒鎬у彲浠ュ皢缁嗚優鍒嗙被銆傜粡涓€绉嶆垨鍑犵鐗规畩鑽у厜鏍囪鐨勬牱鏈紝鍦ㄦ縺鍏夋潫鐨勬縺鍙戜笅鎵€浜х敓鐨勭壒瀹氳崸鍏夛紝鍙鍏夊绯荤粺妫€娴嬪苟杈撻€佸埌璁＄畻鏈鸿繘琛屽垎鏋愶紝寰楀埌缁嗚優鐩稿簲鐨勫悇绉嶇壒鎬с€侟/p>
涓村簥搴旂敤
- nCD64鍦ㄧ粏鑿屾劅鏌撹瘖鏂腑鐨勫簲鐢細杩戝勾鏉ュぇ閲忕爺绌舵彁鍑簄CD64鐨勮〃杈惧彲浣滀负缁嗚弻鎰熸煋鏃╂湡璇婃柇鍙婇鍚庤瘎浼扮殑鏂版寚鏍嘃span style="color:hsl(212,80%,42%);">[5, 6]銆備竴椤硅崯钀冨垎鏋愮撼鍏?006骞磋嚦2017骞?4椤圭爺绌剁殑2471渚嬫偅鑰咃紝灏界鍥犱负鍚勭爺绌舵娴嬪垎鏋愭柟娉曚笉鍚岃€屾棤娉曟瘮杈冧复鐣屽€硷紝浣嗕粛鍙戠幇nCD64鍦ㄨ瘖鏂垚浜鸿創姣掔棁涓湁杈冮珮鐨勭伒鏁忓害 (87%) 鍜岀壒寮傚害 (89%) [7]銆侷cardi绛?2009)鐮旂┒琛ㄦ槑锛屽綋CD64鎸囨暟≤1.19鏃讹紝鍙帓闄ょ粏鑿屾劅鏌擄紝CD64鎸囨暟>1.19鏃跺彲璇婃柇涓虹粏鑿屾劅鏌擄紝涓旀晱鎰熷害鍙婄壒寮傚害鍒嗗埆涓?4.6%銆?8.7%锛岄槼鎬ч娴嬪€间负89.8%锛岄槾鎬ч娴嬪€间负94.0%[8]銆侰id绛?2010)鍒嗘瀽浜?002骞磋嚦2009骞寸殑1921渚嬬枒浼兼劅鏌撹€咃紝鍙戠幇nCD64鍦ㄦ垚浜轰腑鐢ㄤ簬鏃╂湡璇婃柇缁嗚弻鎰熸煋鐨勭伒鏁忓害鍜岀壒寮傚害 (90%銆?5%) 浼樹簬鍎跨 (71%銆?7%)[9]銆傝€屽ICU鎮ｈ€呭湪鍏ラ櫌24h鍐呮娴嬪叾nCD64琛ㄨ揪鎯呭喌锛屽彂鐜拌創姣掔棁鎮ｈ€卬CD64琛ㄨ揪姘村钩楂樹簬闈炶創姣掔棁鎮ｈ€咃紝涓攏CD64琛ㄨ揪涓嶤RP鍛堟槑鏄炬鐩稿叧 (r=0.56)[10]銆傜粡杩囨湁鏁堢殑鎶楄弻鑽墿娌荤枟锛岃創姣掔棁鎮ｈ€卬CD64琛ㄨ揪鍦ㄥ叆闄㈠悗绗?澶╁紑濮嬩笅闄嶏紝涓攏CD64鐨勯珮琛ㄨ揪涓庣柧鐥呬弗閲嶇▼搴︾浉鍏筹紝鍙戠敓鑴撴瘨鐥囦紤鍏嬬殑鎮ｈ€呭叾nCD64琛ㄨ揪閲忔洿楂楛span style="color:hsl(212,80%,42%);">[11]銆侟/li>
- nCD64鍦ㄦ劅鏌撴€у強闈炴劅鏌撶値鎬х柧鐥呬腑鐨勯壌鍒瘖鏂环鍊硷細缁忓吀鍙戠儹寰呮煡鐥呭洜鍒嗙被涓富瑕佹槸鎰熸煋鎬у拰闈炴劅鏌撴€э紝涓村簥涓婇潪甯搁渶瑕佸彲鐢ㄤ簬閴村埆鎰熸煋鍜岄潪鎰熸煋鐐庢€х柧鐥呯殑鏈夋晥鎵嬫銆俋iong绛夋娴嬩簡356渚嬪彂鐑緟鏌ユ偅鑰呯殑nCD64鎸囨暟锛屽彂鐜板綋nCD64鎸囨暟澶т簬5.06鏃跺彲浠ュ尯鍒嗘劅鏌撴€у拰闈炴劅鏌撴€у彂鐑?span style="color:hsl(212,80%,42%);">[12]銆傜被椋庢箍鍏宠妭鐐?RA)鍚堝苟鎰熸煋鐨勭梾鍘熺绫诲鏍凤紝鍖呮嫭缁嗚弻銆佺粨鏍稿垎鏋濇潌鑿屻€佺梾姣掑拰鐪熻弻锛屽潎瑙傚療鍒皀CD64>2000鍒嗗瓙閲?缁嗚優锛屽叾涓粨鏍稿垎鏋濇潌鑿屾劅鏌撴湁楂樹簬鍏朵粬鐥呭師浣撶殑瓒嬪娍锛屼笖鍏惰〃杈句笂璋冧笌鎮ｈ€呮槸鍚︿娇鐢ㄨ繃绯栫毊璐ㄦ縺绱犮€佹姉椋庢箍鑽墿鎴栫敓鐗╁埗鍓傛棤鍏颤span style="color:hsl(212,80%,42%);">[13, 14]銆傜郴缁熸€х孩鏂戠嫾鐤椿鍔ㄦ湡涓庨潤姝㈡湡CD64鐨勮〃杈惧熀鏈竴鑷达紝骞跺彂鎰熸煋鎮ｈ€匔D64鐨勮〃杈炬槑鏄鹃珮浜庢湭骞跺彂鎰熸煋鎮ｈ€呭拰鍋ュ悍浜猴紝绯荤粺鎬х孩鏂戠嫾鐤偅鑰匔D64鐨勬樉钁楀崌楂樻彁绀烘湁鎰熸煋锛岃€屼笌鐤剧梾娲诲姩搴︽棤鍏颤span style="color:hsl(212,80%,42%);">[15]銆傚湪闈炴劅鏌撶値鎬х柧鐥呬腑锛岃绠＄値鎮ｈ€卬CD64鐨勮〃杈鹃珮浜庡叾浠栭潪琛€绠＄値闈炴劅鏌撶値鎬х柧鐥呭RA銆佺郴缁熸€х孩鏂戠嫾鐤?SLE)銆佺棝椋庛€佽剨鏌卞叧鑺傜梾銆佺毊鑲岀値鍜屽鏃忔€у湴涓捣鐑偅鑰咃紝涓斿弽鏄犵柧鐥呮椿鍔ㄧ殑鎸囨爣ESR涓巒CD64琛ㄨ揪涔熸棤鐩稿叧鎬?span style="color:hsl(212,80%,42%);">[14]銆傚湪Behcet鐥呭拰鑷韩鍏嶇柅鎬х値鐥囨€ц偁鐥呯殑鐮旂┒涓彂鐜帮紝CD64鍙尯鍒嗙柧鐥呯殑娲诲姩鏈熷拰鎰熸煋鎬х柧鐥匋span style="color:hsl(212,80%,42%);">[16, 17]銆傛湁鐮旂┒灏嗚嚜韬厤鐤梾鍒嗕负闈炴椿鍔ㄧ粍銆佹椿鍔ㄧ粍鍜屽悎骞舵劅鏌撶粍锛屽彂鐜皀CD64鍦ㄦ3缁勪腑鐨勮〃杈句緷娆″崌楂橈紝鏈夊姪浜庡湪鑷韩鍏嶇柅鐥呬腑閴村埆鎮ｈ€呮槸鍚︽劅鏌掽span style="color:hsl(212,80%,42%);">[18]銆侟/li>
- nCD64鍦ㄧ洃娴嬫姉鑿岃嵂鐗╃殑鐤楁晥銆佺梾鎯呰瘎浼板強鐤剧梾棰勫悗鍒ゆ柇涓殑搴旂敤锛欬/strong>浣滀负涓€绉嶅弽鏄犳劅鏌撶姸鎬佺殑鏁忔劅鎸囨爣锛孋D64鍙敤浜庣洃娴嬫姉鑿岃嵂鐗╃殑涓村簥鐤楁晥銆?016骞碤ian绛堻span style="color:hsl(212,80%,42%);">[19]瀵笴D64鍦ㄧ粏鑿屾劅鏌撹鍙戞參鎬ч樆濉炴€ц偤鐤剧梾(COPD)鎬ユ€у姞閲嶆棭鏈熻瘖鏂腑鐨勪环鍊煎紑灞曠浉鍏崇爺绌讹紝缁撴灉鏄剧ずCD64鎸囧缁 (CD64≥7.0)涓庡父瑙勬不鐤楃粍(4.0
- nCD64浣滀负澶栫鎵嬫湳涓洃娴嬫槸鍚﹀苟鍙戞劅鏌撶殑鎸囨爣锛欬/strong>Strohmeyer绛堻span style="color:hsl(212,80%,42%);">[22]鎶ラ亾蹇冭偤鍒嗘祦鏈悗绗?澶╋紝鎵€鏈夋墜鏈偅鑰呯敱浜庡櫒姊版崯浼D64鍧囧崌楂橈紝浣嗘湭鎰熸煋鎮ｈ€呮湳鍚?~5d CD64鎭㈠姝ｅ父锛屽悎骞舵劅鏌撶殑鎮ｈ€呮湳鍚?d浠ュ悗浠嶇劧鎸佺画楂樻按骞筹紝鍥犳CD64鍙洃娴嬫湳鍚庢槸鍚﹀苟鍙戞劅鏌撱€侳jaertoft绛堻span style="color:hsl(212,80%,42%);">[23]鍦ㄩ珛鍏宠妭鎴愬舰鏈腑涔熻瀵熷埌CD64鍙綔涓洪壌鍒粏鑿屾劅鏌撴垨鎵嬫湳鍒涗激鐨勬寚鏍囷紝CD64鍦ㄦ湳鍚庣1澶╁崌楂橈紝绗?澶╄揪鍒板嘲鍊硷紝3d鍚庝笅闄岥骞跺彂缁嗚弻鎰熸煋鏃禖D64鍗囬珮骞呭害鏄庢樉楂樹簬鎵嬫湳鍒涗激锛屾寔缁椂闂磋秴杩囧崟浣撴墜鏈崌楂樼殑鏃堕棿銆侟/li>
閫傜敤绉戝
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[1] Hoffmann JJ. Neutrophil CD64 as a sepsis biomarker. Biochem Med (Zagreb). 2011;21(3):282-90.
[2] Mancardi DA, Albanesi M, J枚nsson F, Iannascoli B, Van Rooijen N, Kang X, England P, Da毛ron M, Bruhns P. The high-affinity human IgG receptor FcγRI (CD64) promotes IgG-mediated inflammation, anaphylaxis, and antitumor immunotherapy. Blood. 2013 Feb 28;121(9):1563-73.
[3] 闊╀附濞?鑽ｄ箟杈? 鎰熸煋鎬х柧鐥呭簲鐢ㄤ腑鎬х矑缁嗚優CD64鐨勭爺绌惰繘灞昜J]. 涓浗缁х画鍖诲鏁欒偛,2021,13(14):195-198.
[4] 鏉庤晩,甯镐寒,鏉庨噾娲?绛? CD64鍦ㄥ嵄閲嶇柧鐥呭悎骞舵劅鏌撹瘖鏂腑鐨勫簲鐢ㄨ繘灞昜J]. 涓村簥妫€楠屾潅蹇?2019,37(7):531-534.
[5] ten Oever J, Netea MG, Kullberg BJ. Utility of immune response-derived biomarkers in the differential diagnosis of inflammatory disorders. J Infect. 2016 Jan;72(1):1-18.
[6] J盲ms盲 J, Ala-Kokko T, Huotari V, Ohtonen P, Savolainen ER, Syrj盲l盲 H. Neutrophil CD64, C-reactive protein, and procalcitonin in the identification of sepsis in the ICU - Post-test probabilities. J Crit Care. 2018 Feb;43:139-142.
[7] Yeh CF, Wu CC, Liu SH, Chen KF. Comparison of the accuracy of neutrophil CD64, procalcitonin, and C-reactive protein for sepsis identification: a systematic review and meta-analysis. Ann Intensive Care. 2019 Jan 8;9(1):5.
[8] Icardi M, Erickson Y, Kilborn S, Stewart B, Grief B, Scharnweber G. CD64 index provides simple and predictive testing for detection and monitoring of sepsis and bacterial infection in hospital patients. J Clin Microbiol. 2009 Dec;47(12):3914-9.
[9] Cid J, Aguinaco R, S谩nchez R, Garc铆a-Pardo G, Llorente A. Neutrophil CD64 expression as marker of bacterial infection: a systematic review and meta-analysis. J Infect. 2010 May;60(5):313-9.
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[15] 鏉ㄦ棴鐕?鏋楄繘,鍘夋湁鍚? 绯荤粺鎬х孩鏂戠嫾鐤偅鑰呭鍛ㄨ涓€х矑缁嗚優CD64鐨勮〃杈綶J]. 涓崕鍐呯鏉傚織,2003,42(12):854-856.
[16] Ureten K, Ertenli I, Ozt眉rk MA, Kiraz S, Onat AM, Tuncer M, Okur H, Akdogan A, Apras S, Calg眉neri M. Neutrophil CD64 expression in Beh莽et's disease. J Rheumatol. 2005 May;32(5):849-52.
[17] Tillinger W, Jilch R, Jilma B, Brunner H, Koeller U, Lichtenberger C, Waldh枚r T, Reinisch W. Expression of the high-affinity IgG receptor FcRI (CD64) in patients with inflammatory bowel disease: a new biomarker for gastroenterologic diagnostics. Am J Gastroenterol. 2009 Jan;104(1):102-9.
[18] Hussein OA, El-Toukhy MA, El-Rahman HS. Neutrophil CD64 expression in inflammatory autoimmune diseases: its value in distinguishing infection from disease flare. Immunol Invest. 2010;39(7):699-712.
[19] Qian W, Huang GZ. Neutrophil CD64 as a Marker of Bacterial Infection in Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Immunol Invest. 2016 Aug;45(6):490-503.
[20] Skirecki T, Mikaszewska-Sokolewicz M, Hoser G, Zieli艅ska-Borkowska U. The Early Expression of HLA-DR and CD64 Myeloid Markers Is Specifically Compartmentalized in the Blood and Lungs of Patients with Septic Shock. Mediators Inflamm. 2016;2016:3074902.
[21] Muzlovic, I., A. Ihan, and D. Stubljar, CD64 index on neutrophils can diagnose sepsis and predict 30-day survival in subjects after ventilator-associated pneumonia. J Infect Dev Ctries, 2016. 10(3): p. 260-8.
[22] Strohmeyer, J.C., et al., Standardized immune monitoring for the prediction of infections after cardiopulmonary bypass surgery in risk patients. Cytometry B Clin Cytom, 2003. 53(1): p. 54-62.
[23] Fjaertoft, G., et al., Neutrophil CD64 (FcgammaRI) expression is a specific marker of bacterial infection: a study on the kinetics and the impact of major surgery. Scand J Infect Dis, 2007. 39(6-7): p. 525-35.
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