小儿脓毒症CD62p、CD63及CD64分子变化及临床意义探讨

目的探讨脓毒症患儿血小板仅颗粒膜糖蛋白（CD62p）、溶酶体膜蛋白（CD63）及中性粒细胞表面膜糖蛋白（CD64）的变化及意义。方法2010年3月至2013年3月哈尔滨市儿童医院感染内科收治的脓毒症患儿56例，其中严重脓毒症16例，一般脓毒症40例，另设健康对照组34例。应用流式细胞术检测儿童外周血的血小板表面活性标记糖蛋白CD62p、CD63及中性粒细胞CD64表达，并进行比较。结果严重脓毒症组患儿外周血的CD62p、CD63及CD64水平明显高于一般脓毒症组，差异有统计学意义（P〈0．01）；一般脓毒症组患儿CD62p、CD63及CD64水平明显高于健康对照组，差异有统计学意义（P〈0．01）。相关性分析显示，脓毒症患儿的CD62p、CD63与CD64水平呈正相关（r=0．817、0．796，P均〈0．001），CD62p、CD63、CD64水平与小儿危重病例评分呈正相关（CD62p：r=0．883，P〈0．001；CD63：r=0．862，P〈0．001；CD64：r=0．805，P〈0．001）。结论CD62p、CD63、CD64与感染和炎症严重程度密切相关，可作为评价疾病严重程度及预后的指标。

The expression and dinical significance of CD62p,CD63 and CD64 in children with sepsis

Objective To investigate the expression and clinical significance of platelet glycoprotein CD62p,CD63 and neutrophil surface CD64 in sepsis. Methods Fifty-six children with sepsis from March 2010 to March 2013 in Communicable Disease Department of our hospital were divided into severe sepsis group（n = 16） and general sepsis group（ n = 40）, normal control group included 34 subjects from health check. CD62p, CD63 and CD64 were detected by flow cytometry in children with sepsis, and compared with normal control group. Results The levels of CD62p, CD63 and CD64 in severe sepsis group were higher than those of general sepsis group（ P 〈0. 01 ）. The levels of CD62p,CD63 and CD64 in general sepsis group were higher than those of normal control group （ P 〈 0. 01 ）. Correlation analysis indicated that CD62p and CD63 were in positive correlation with CD64 in children with sepsis （ r = 0. 817,0. 796, P 〈 0. 001 ）. The positive correlations of CD62p,CD63 and CD64 with pediatric critical illness score were also found（ CD62p：r = 0.883,P〈O. OO1;CD63：r=0. 862,P〈0.001;CD64：r=0. 805,P〈0.001）.Conclusion CD62p, CD63 and CD64 are closely related to the severity of infection and diseases, and may be used as immune parameters for the estimation of the clinical severity and the prognosis of acute and severe diseases.