中性粒细胞VCS参数在呼吸系统细菌感染性疾病中的变化及临床应用  

The value and clinical application of the determination of neutrophil VCS parameters in the diagnosis of respiratory system infectious diseases

作　　者：俞蕾[1] 翁文浩[1] 施惠兰[1] 张蕾[1] 汪嘉[1] 李智[1] 

机构地区：[1]同济大学附属第十人民医院检验科,上海市200072

出　　处：《实用检验医师杂志》2012年第1期39-42,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的通过检测呼吸系统细菌感染患者的中性粒细胞参数VCS的变化，探讨其临床应用价值。方法利用全自动血细胞分析仪的细胞体积、高频电流传导、激光散射（VCS）技术，测定50例健康者（对照组）和60例确诊细菌感染患者（感染组）WBC计数、中性粒细胞百分比（percentageofneu-trophil，NE％）、中性粒细胞VCS参数及其各自标准差（standarddeviation，SD）。同时检测C反应蛋白（Creactionprotein，CRP），并对检测结果进行统计学分析。结果感染组患者WBC、NE％、V、V-SD、C、CRP检测水平均高于对照组，且差异均有统计学意义（P均〈0．05）。感染组2中WBC、NE％、V-SD、CRP检测水平均高于感染组1，且差异均有统计学意义（P均〈0．05）。感染组患者C-SD、S、S-SD检测水平与对照组比较差异均无统计学意义（P均〉0．05）。根据受试者工作特征（receiveroperatingcharacteristic，ROC）曲线判断WBC、NE％、CRP、V及V-SD的cutoff值分别为8．4xlOg／L、70％、6．6mg／L、144和20．45。其中NE％＋CRP、WBC＋CRP＋V-SD、NE％＋CRP＋V-SD三种组合诊断细菌感染的灵敏度、特异性均高于80％。ROC曲线表明CRP、NE％诊断细菌感染效能优秀，曲线下面积（areaundercure，AUC）分别为0．89、0．87，V及V-SD一般，AUC^ROC分别为0．75、0．74，而WBC诊断效能最差，AUC^ROC为O．67。结论呼吸系统细菌感染患者的中性粒细胞体积参数V及V-SD变化较为灵敏，与WBC、NE％和CRP联合诊断时可明显提高灵敏度，同时WBC、NE％和CRP有较好特异性，可为临床判断呼吸系统细菌感染起到很好的提示作用。Objective To detect the changes and explore the clinical significance of the neutrophil VCS parameters in the patients with respiratory system infectious diseases. Methods 50 normal persons（con- trol group） and 60 patients with diagnosed respiratory system infections （infected group） were selected in this study. Data included total WBC counts, percentage of neutrophil （NE%）, the VCS parameters and standard deviation （SD） of neutrophil, were measured by the automatic blood cell analyzer. C reactive protein （CRP） was measured simuhaneously and the results were statistically analyzed. Results The levels of WBC, NE%, V, V-SD, C and CRP in infected group were all higher than in control group, and the differences all had statistical significance （Pall〈 0.05）. The levels of WBC, NE%, V-SD and CRP in infected group 2 were all higher than in infected group 1, and the differences all had statistical significance （Pall〈 0.05）. There were no statistical significance in the differences of C-SD, S, S-SD levels between infected group and control group（Pall〉 0.05 ）. The cutoff vallue of WBC, NE%, CRP, V and V-SD were 8.4×109/L, 70%, 6.6 mg/L, 144 and 20.45 re- spectively according to receiver operating characteristic （ROC） curve. The sensitivity and specificity of combi- nation detection of NE%＋CRP, WBC＋CRP＋V-SD, NE%＋CRP＋V-SD were all higer than 80%. According to the ROC curve, the efficient of CRP and NE% were excellent, the area under curve （AUC） were 0.89, 0.87 respectively. V and V-SD were general, AUCROC were 0.75, 0.74, and the WBC was worse, AUCROC was 0.67. Conclusion The neutrophil V and V-SD change significantly in the patients with respiratory system infec- tions. The sensitivity and specificity are greatly improved when the combination of WBC, NE%, CRP and V/ V-SD were used and it may provide help for diagnosis of respiratory system infectious diseases.

关 键 词：呼吸系统感染 细菌感染 VCS参数 白细胞 C反应蛋白 

分 类 号：R978.1[医药卫生—药品]