KHẢO SÁT GIÁ TRỊ CỦA CD64 TRÊN BẠCH CẦU HẠT TRUNG TÍNH, HLA-DR TRÊN BẠCH CẦU ĐƠN NHÂN VÀ MỘT SỐ DẤU ẤN SINH HỌC KHÁC TRONG CHẨN ĐOÁN NHIỄM KHUẨN HUYẾT Ở BỆNH VIỆN QUÂN Y 175

Abstract

Objectives: To investigate the diagnostic value of neutrophil CD64 (nCD64), monocytic HLA-DR (mHLA-DR), and other biomarkers (sepsis index, procalcitonin, white blood count) in the diagnosis of sepsis. Methods: A retrospective, cross-sectional descriptive study was conducted on 86 patients treated at the Department of Infectious Diseases, Military Hospital 175, from October 2024 to April 2025. Results: There were statistically significant differences in the median values of nCD64, mHLA-DR, and SI between patients with sepsis and non-sepsis. SI and nCD64 demonstrated a strong diagnostic performance for sepsis, with areas under the curve (AUC) of 0.90 and 0.87, p < 0.01. These values were superior to those of mHLA-DR (AUC = 0.31), PCT (AUC = 0.81), and white blood count (WBC) (AUC = 0.7). nCD64 showed a sensitivity of 84.6% and a specificity of 79.4% at a cut-off value of 3029 molecules/cell. For SI, at a cut-off value of SI ≥ 16.3, the sensitivity and specificity were 94.2% and 79.4%, respectively. The combined use of nCD64, mHLA-DR, and PCT yielded the highest diagnostic accuracy, with an AUC of 0.94 (95%CI: 0.90 - 0.99; p < 0.01). Conclusion: SI and nCD64 showed high valuable in diagnosing sepsis, with high sensitivity. The combined assessment of nCD64, mHLA-DR, SI, PCT, and WBC further improved the diagnostic accuracy for sepsis.