The Clinical Value Study Of The Expression Of PMN Index In The Sepsis

Objectivel.To observe the expression level of PMN Index(CD64+/CD163-Index) in the sepsis. Kinesis monitoring sepsis patients to observe the chang level of the index, so that it could provide a more accurate and more valuable evidence for the development course of disease and prognosis of the patients.2. To observe the expression level of PMN Index (CD64+/CD163-Index) in non-sepsis infectious patients(including pulmonary infectious patients, urinary system infectious patients, etc), non-infectious patients (including CAD patients, HBP patients, MI patients, etc). Compared with sepsis patients to observe the relationship between the expression and the course of disease.3.To detect the serology indexes at equal pace, such as PCT, CRP and WBC. To analyze all the detection results with statistics software to observe the relationship among PMN Index with these indexes.4. Compared PMN Index with HLA-DR/CD14and CD4+CD25+CD127LOWTreg to deeply observe the relationship among these indexes in infectious diseases.Methods1. Disease groups:Collecting32cases of EDTA-K3anticoagulation blood preparation of the sepsis group, selecting10cases for kinesis monitoring,30cases of the non-sepsis infection group(including pulmonary infectious patients, urinary system infectious patients, etc),35cases of the non-infection group(including CAD patients, HBP patients, MI patients, etc). Detected the PMN Index with the flow cytometry, and analyzed the results with SPSS13.0.2. Normal control group:Collecting30cases of EDTA-K3anticoagulation blood preparation of the normal control group. Detected the PMN Index with the flow cytometry, and analyzed the results with SPSS13.0. 3. Collecting the anticoagulation blood preparation and serum specimen of all groups at equal pace. Detected PCT with ELFA, CRP with immuno-scatter nephelometry, WBC with automatic blood count, HLA-DR/CD14and CD4+CD25+CD127L0WTreg with the flow cytometry.4. Analyzed the change of PMN Index during the healing process in sepsis patients to find out the relationship with the course of disease. Using SPSS13.0to analyze the results with ANOVA and compare the correlation, and draw a ROC curve.5. To observe the change degree of morphous and formation of PMN with TEM during the course of disease, to validate the effect of PMN Index during the course of disease. Results1. The experiment discovered that, the PMN Index and other indexes of the sepsis group and the non-sepsis infection group were more higher than the non-infection group and the normal control group.There were significant difference among them. The PMN Index and PCT of the sepsis group were higher than the non-sepsis infection group, there were significant difference between them. There were positive correlation among the PMN Index and PCT, CRP, there was no correlation between the PMN Index with WBC.2. The research found that, there were significant difference among the PMN Index and HLA-DR/CD14, CD4+CD25+CD127LOWTreg of the sepsis group and the non-infection group, the normal control group. There were significant difference between the PMN Index with HLA-DR/CD14of the sepsis group with non-sepsis infection group. There were negative correlation between the PMN Index with HLA-DR/CD14, there was no correlation between the PMN Index with CD4+CD25+CD127L0"Treg.3. TEM validation:The phenomenon of shift to the left and toxic granulation were observed in the specimen of the sepsis group. And major electron-dense cells, low electron density granulation or big vacuolus also could be observed. Deeper the color, higher the electron density. With the lessen of the course of disease, the electron-dense cells decreased gradually, the electron density attenuated gradually. New ideas of this paper:1. Detected the PMN Index with FLA and the flow cytometry,the detection of MN CD163was added to deplete the interference of MN CD64, made sure the result more accuratissime.2. The experiment discovered that the PMN Index correlated with the prognosis of the disease with1st,3rd,6th,9th kinesis monitoring of sepsis patients.3. The correlation between the structural change of PMN with the chang of the PMN Index was validated with TEM, and the change matched the prognosis of the disease.ConclusionThe PMN Index of sepsis patients is obviously higher than the normal people, it has an important value in the infectious diseases. The PMN Index could be used to evaluate the course of disease and to observe the therapeutic effect of infectious diseases according to the results of kinesis monitoring and TEM.