鑴撴瘨鐥囨娴嬭瘯鍓傜洅(娴佸紡缁嗚優浠硶)
--鑴撴瘨鐥囨娴婞/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>
鑴撴瘨鐥?sepsis)鏄劅鏌撳紩璧峰涓诲弽搴斿け璋冿紝瀵艰嚧鍗卞強鐢熷懡鐨勫櫒瀹樺姛鑳芥崯瀹崇殑鐥囧€欑兢锛屾槸涓€涓珮鐥呮鐜囩殑涓村簥缁煎悎寰併€傚湪浣庢敹鍏ュ強涓瓑鏀跺叆鐨勫浗瀹讹紝姣掔棁鏇存槸閲嶇棁鐩戞姢鐥呮埧(ICU)鎮ｈ€呯殑涓昏姝讳骸鍘熷洜锛屾浜＄巼楂樿揪80%銆備笘鐣屽崼鐢熺粍缁囧凡缁忚璇嗗埌鑴撴瘨鐥囧鍏ㄧ悆鍋ュ悍鐨勯噸澶у▉鑳侊紝骞跺姞寮轰簡瀵硅創姣掔棁鐨勯闃层€佽瘖鏂拰娌荤枟銆傚敖绠″姝わ紝鑴撴瘨鐥囩殑姝讳骸鐜囦緷鐒跺緢楂橈紝涓昏鍘熷洜涔嬩竴鏄洰鍓嶅苟娌℃湁璇婃柇鑴撴瘨鐥囩殑閲戞爣鍑嗭紝涓村簥缂轰箯鏃╂湡璇婃柇鍜岀梾鎯呴娴嬬殑鎵嬫銆侟/p>
CD64 鏄厤鐤悆铔嬬櫧 G ( IgG) Fc娈靛彈浣撲箣涓€锛屽睘浜庡厤鐤悆铔嬬櫧瓒呭鏃忕殑鎴愬憳锛岀浉瀵瑰垎瀛愯川閲忎负 72 000锛岀敱鏌撹壊浣?q21.2锝瀜21.3 缂栫爜銆侰D64 涓昏鍒嗗竷浜庢穻宸寸粏鑳炪€佸法鍣粏鑳炪€佸崟鏍哥粏鑳炲拰鏍戠獊缁嗚優琛ㄩ潰锛屽叾琛ㄨ揪鍙楃粏鑳炲洜瀛愮殑璋冭妭銆傚湪鏈劅鏌撴垨闈炵柧鐥呯姸鎬佹椂锛孋D64鍦ㄤ腑鎬х矑缁嗚優涓婂浜庝綆姘村钩琛ㄨ揪锛屼絾褰撲綋澶栫梾鍘熶綋渚靛叆鏃讹紝鎶楀師鎴栫値鐥囧洜瀛愪細瀵艰嚧涓€х矑缁嗚優涓婄殑CD64琛ㄨ揪涓婅皟锛屾渶楂樺彲杈?0鍊嶃€侟/p>
浜虹被鐧界粏鑳炴姉鍘?DR (Human leukocyte antigen-DR锛孒LA-DR) 鏄竴绉嶅湪鎶楀師鎻愬憟缁嗚優涓婅〃杈剧殑绯栧熀鍖栫粏鑳炶〃闈㈣啘铔嬬櫧锛屽湪鍗曟牳缁嗚優涓婃湁缁勬垚鎬ц〃杈俱€侶LA-DR鍦ㄦ劅鏌撲腑鐨勪富瑕佷綔鐢ㄦ槸T杈呭姪缁嗚優鐨勬姉鍘熷憟閫掞紝瀵艰嚧淇冪値缁嗚優鍥犲瓙鐨勯噴鏀俱€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
- CD64鎸囨暟璇婃柇缁嗚弻鎬ф劅鏌撴€х柧鐥呯殑闃虫€ч娴嬪€笺€侀槾鎬ч娴嬪€笺€佺伒鏁忓害鍜岀壒寮傛€э紝鏅亶楂樹簬寰敓鐗╁煿鍏汇€佺櫧缁嗚優璁℃暟鍙婂垎绫汇€丆鍙嶅簲铔嬬櫧 (CRP)銆侀檷閽欑礌鍘?PCT)浠ュ強琛€娓呮穩绮夋牱铔嬬櫧A绛変紶缁熸劅鏌撴寚鏍嘃span style="color:hsl(212,80%,42%);">[1-3]銆侟/li>
- CD64鎰熸煋鎸囨暟妫€娴嬬殑涓村簥鎰忎箟鍖呮嫭锛?) 楂樻晱鎰熴€侀珮鐗瑰紓鐨勮瘖鏂劅鏌撴€х柧鐥呯殑鏃╂湡鏍囧織鐗┿€傝創姣掔棁鐨勬棭鏈熻瘖鏂浜庡強鏃舵不鐤楄嚦鍏抽噸瑕併€俷CD64鍦ㄦ劅鏌撳彂鐢熷悗鐨勬棭鏈熼樁娈靛嵆鍙崌楂橈紝鍥犳鍙互浣滀负鏃╂湡璇婃柇鑴撴瘨鐥囩殑閲嶈鎸囨爣銆?) 鍖哄垎鎰熸煋鎬х値鐥囧拰娲诲姩鎬ц嚜韬厤鐤€х柧鐥匊3) 閴村埆缁嗚弻鎰熸煋鎬х柧鐥呭拰鐥呮瘨鎰熸煋鎬х柧鐥匊4) 鎰熸煋绋嬪害璇勪及锛氶€氳繃鐩戞祴nCD64鐨勫彉鍖栵紝鍙互璇勪及鎰熸煋鐨勭▼搴﹀拰涓ラ噸绋嬪害銆傝緝楂樼殑nCD64鏁板€煎彲鑳芥彁绀烘劅鏌撶▼搴︽洿涓轰弗閲嶏紝浠庤€屾寚瀵煎尰鐢熻繘琛屾洿鍔犵Н鏋佺殑娌荤枟绛栫暐銆?)瀵硅創姣掔棁鎮ｈ€呰繘琛岄鍚庤瘎浼?6)鎶楄弻鑽墿鐤楁晥鐩戞祴骞堕娴嬫湳鍚庢劅鏌撱€傚湪娌荤枟鑴撴瘨鐥囩殑杩囩▼涓紝鐩戞祴nCD64鐨勫彉鍖栧彲浠ヨ瘎浼版不鐤楃殑鏁堟灉銆傚鏋滄寚鏁颁笅闄嶏紝鍒欒鏄庢不鐤楁湁鏁堟€ц緝楂楙鍙嶄箣锛屾寚鏁版寔缁笂鍗囧彲鑳芥彁绀洪渶瑕佽皟鏁存不鐤楁柟妗堛€?)涓綋鍖栨不鐤楋細姣忎釜鎮ｈ€呰創姣掔棁鐨勪弗閲嶇▼搴︽槸涓嶅悓鐨勶紝鍥犳涓綋鍖栨不鐤楀彉寰楄嚦鍏抽噸瑕併€俷CD64鍙互甯姪鍖荤敓鏇村ソ鍦颁簡瑙ｆ偅鑰呯殑鍏嶇柅鐘舵€侊紝浠庤€屽埗瀹氶拡瀵规€х殑娌荤枟璁″垝銆侟/li>
- 浣巑HLA-DR琛ㄨ揪浣滀负鍗曟牳缁嗚優鍔熻兘闅滅鍜屽厤鐤姂鍒剁殑鏍囧織锛屾殏鏃跺瓨鍦ㄤ簬ICU鏀舵不鐨勫ぇ澶氭暟鍗遍噸鐥囨偅鑰呬腑(鑴撴瘨鐥囥€佸垱浼ゆ崯浼ゃ€佹湳鍚庛€佺儳浼ゃ€佽儼鑵虹値鍜屼腑椋?銆俶HLA-DR琛ㄨ揪鐨勯檷浣庢槸鎵€鏈夎繖浜涗复搴婃潯浠朵笅鑴撴瘨鐥囧苟鍙戠棁鐨勪竴涓娴嬪洜瀛愩€侟/li>
- HLA-DR鐨勪綆琛ㄨ揪涓庤創姣掔棁鐨勬浜＄巼鍛堟鐩稿叧锛屼笖褰撳崟鏍哥粏鑳炰笂HLA-DR琛ㄨ揪灏忎簬30%鏃跺彲浠ュ彲闈犲湴绛涢€夊嚭鑴撴瘨鐥囧厤鐤姂鍒舵偅鑰咃紝涓斾笌涓嶈壇棰勫悗鍏锋湁楂樼浉鍏虫€?span style="color:hsl(212,80%,42%);">[4]銆侟/li>
- CD64鍜孒LA-DR鑱旀锛欳lara Giffoni de Freitas绛?2023)鐮旂┒璁や负锛屽崟鏍哥粏鑳炰腑HLA-DR鐨勮〃杈惧拰涓€х矑缁嗚優涓瑿D64鐨勮〃杈惧彲浣滀负鎰熸煋鐐庣棁杩囩▼涓創姣掔棁/SIRS鐨勯娴嬪洜瀛忺span style="color:hsl(212,80%,42%);">[5]HLA-DR銆丆D64鍜屾柊鎸囨暟鐨勪娇鐢ㄥ湪璇嗗埆鑴撴瘨鐥囨柟闈㈡樉绀哄嚭鏇撮珮鐨勬晱鎰熸€у拰鐗瑰紓鎬э紝杩欎簺鏍囪鐗╃殑鑱斿悎璇勪及鍙互鎴愪负鑴撴瘨鐥囩殑寮洪娴嬪洜瀛愩€侟/li>
閫傜敤绉戝
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閫傜敤绉戝 |
瀵瑰簲鐤剧梾 |
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閲嶇棁鍖诲绉 |
鐥呮儏鐩戞祴銆佹寚瀵兼不鐤桙/p> |
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鎬ヨ瘖绉 |
鏃╂湡璇婃柇銆佺梾鎯呰瘎浼颁笌鍒嗗眰 |
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鎰熸煋绉 |
瀵逛簬鎰熸煋绉戞敹娌荤殑鍚勭被鎰熸煋鎬х柧鐥呮偅鑰匋/p> |
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鍛煎惛鍐呯 |
鍖婚櫌鑾峰緱鎬ц偤鐐庣瓑鎰熸煋鎬х柧鐥呰瘖鏂?/p> |
鍙傝€冩枃鐚?/h3>
[1] 闄堟睙, et al., CD64鎰熸煋鎸囨暟涓庣粏鑿屾劅鏌撶浉鍏虫€х爺绌? 妫€楠屽尰瀛︿笌涓村簥, 2017. 14(7): p. 3.
[2] 鐢勭礌鑺? 鏇圭帀鍏? and 寮犱紵褰? 琛€娓匩EU%,CRP,PCT鍜孋D64鎰熸煋鎸囨暟瀵瑰鍙戞€ч楂撶槫鎮ｈ€呯粏鑿屾劅鏌撶殑璇婃柇鏁堟灉瀵规瘮. 瀹炵敤鐧岀棁鏉傚織, 2021. 36(7): p. 5.
[3] 鍐帀鑾? 灞堟檽濞? and 璨屽溅鏄€, 澶栧懆琛€CD64鎸囨暟鍜岃娓呮穩绮夋牱铔嬬櫧A妫€娴嬪湪瀛﹂緞鍓嶅効绔ョ粏鑿屾劅鏌撹瘖鏂腑鐨勪复搴婃剰涔? 娌冲寳鍖诲, 2021. 27(12): p. 2039-2043.
[4] Venet, F., A. Lepape, and G. Monneret, Clinical review: flow cytometry perspectives in the ICU - from diagnosis of infection to monitoring of injury-induced immune dysfunctions. Critical Care, 2011. 15(5).
[5] de Freitas, C.G. and M.G. Farias, Evaluation of HLA-DR expression in monocytes and CD64 in neutrophils as A predictor of SEPSIS/sirs in the infectious-inflammatory process. Journal of Immunological Methods, 2024. 524: p. 113589.
鎸囧崡鍏辫瘑
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搴忓彿 |
鎸囧崡/鍏辫瘑鍚嶇О |
瑕佺偣 |
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1 |
缇庡浗浼戞柉椤垮嵄閲嶇棁骞翠細 銆?012 骞存嫰鏁戣創姣掔棁杩愬姩鎰熸煋鎬т紤鍏嬫寚鍗椼€婞/p> |
杩樺彲閫氳繃鐩戞祴鍏嶇柅缁嗚優鍔熻兘锛屽CD14锛嬪崟鏍哥粏鑳濰LA-DR琛ㄨ揪銆丆D64鍜岄珦缁嗚優瑙﹀彂鍙椾綋-1锛圱REM-1锛夌殑琛ㄨ揪锛屽弽鏄犱腑鎬х矑缁嗚優鍜屽崟鏍哥粏鑳炲姛鑳斤紝闂存帴鍒ゆ柇鑴撴瘨鐥囨満浣撶殑鍏嶇柅鐘舵€併€侟strong>CD14锛嬪崟鏍哥粏鑳濰LA-DR琛ㄨ揪宸插箍娉涚敤浜庝复搴婏紝璇婃柇鏁堝姏涓庨檷閽欑礌鍘燂紙PCT锛夌浉褰擄紝鍙弽鏄犵柧鐥呯殑涓ラ噸绋嬪害锛屼笌鎮ｈ€呴鍚庡瘑鍒囩浉鍏颤/strong>銆傚厛鍓嶇爺绌跺彂鐜癈D14锛婬LA-DR琛ㄨ揪≤40%鐨勮創姣掔棁鎮ｈ€呯梾姝荤巼瓒呰繃80%锛孋D14锛婬LA-DR琛ㄨ揪≤30%鎮ｈ€呯梾姝荤巼鍙揪100%銆侟strong>CD64琛ㄨ揪鍗囬珮璇婃柇鑴撴瘨鐥囩殑鐗瑰紓鎬ч珮浜嶱CT锛屽彲浣滀负鑴撴瘨鐥囨偅鍎块壌鍒瘖鏂殑闃存€ф帓闄ゆ爣鍑嗗垽鏂苟鍙戣創姣掔棁浼戝厠鐨勯闄?/strong>銆侟/p> |
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2 |
涓浗鐮旂┒鍨嬪尰闄㈠浼氫紤鍏嬩笌鑴撴瘨鐥囦笓涓氬鍛樹細 銆婅創姣掔棁鍏嶇柅鎶戝埗璇婃不涓撳鍏辫瘑銆嬶紙2020锛堻/p> |
涓€х矑缁嗚優鐨勪竴浜涙爣璁扮墿娲诲寲鍙兘浣滀负鑴撴瘨鐥囪瘖鏂殑娼滃湪鐢熺墿鏍囪鐗╋紝渚嬪 CD64 鍜屼汉楂撶郴缁嗚優瑙﹀彂鍙椾綋-1锛圱REM-1锛夈€侟strong>鐢熺悊鎯呭喌涓嬩腑鎬х矑缁嗚優琛ㄩ潰 CD64 琛ㄨ揪寰堜綆锛屼絾琚績鐐庣粏鑳炲洜瀛愬埡婵€鍚庡叾琛ㄨ揪閲忓鍔 10 鍊嶏紝缁嗚弻鎰熸煋鏃 CD64 闃虫€т腑鎬х矑缁嗚優鐧惧垎姣旀樉钁楀崌楂楛/u>銆侟br /> 鍗曟牳缁嗚優HLA-DR锛坢HLA-DR锛夊湪澶氶」骞查鎬т复搴婅瘯楠屼腑閮戒綔涓哄ぉ鐒跺厤鐤殑閲嶈鎸囨爣浣跨敤锛屽苟瑙傚療鍒?strong>鑴撴瘨鐥囨偅鑰呬腑 mHLA-DR 琛ㄨ揪姘村钩寰€寰€杈冨仴搴峰鐓ц€呮槑鏄句笅闄岦/u>銆俶HLA-DR 浣滀负鎮ｈ€呮€讳綋鍏嶇柅鐘舵€佺殑浠ｈ〃鎬ф寚鏍囷紝鍏锋湁鑹ソ鐨勫尯鍒嗗姛鑳姐€傚姩鎬佽瀵 mHLA-DR 姘村钩鍙互鏇村ソ鍦拌瘎浼拌創姣掔棁鎮ｈ€呭厤鐤姸鎬佸拰棰勬祴棰勫悗銆侟/strong> |
鐩稿叧浜у搧
