白细胞参数监测心脏瓣膜术后并发细菌感染的价值  

Prognostic value of leucocyte parameters for monitoring postoperative bacterial infection in patients with cardiac valve replacement

作　　者：曹兴建[1] 朱易华[1] 陆永辉[1] 谢玮[1] 许东生 

机构地区：[1]南通大学附属第二医院检验科,江苏南通226001 [2]波士顿医学中心病理与医学实验室,美国波士顿02118

出　　处：《临床检验杂志》2013年第3期184-186,共3页Chinese Journal of Clinical Laboratory Science

摘　　要：目的探讨白细胞参数在监测术后细菌感染中的价值。方法检测体检健康者和心脏瓣膜置换术后感染、非感染患者术前、术毕及术后第2、3、7天静脉血血常规,记录WBC计数、中性粒细胞百分率(N)、中性粒细胞平均体积(MNV),并计算术后MNV与术前的变化(△MNV),用ROC曲线判断指标辅助诊断术后感染的性能。结果术后感染组和术后非感染组术后第2天MNV、△MNV差异有统计学意义(t分别为6.02、18.76,P<0.01),术后第3天WBC、NE、MNV、△MNV差异有统计学意义(t分别为5.45、3.51、8.97、23.49,P<0.01),术后第7天MNV、△MNV差异有统计学意义(t=5.47、12.24,P<0.01);经ROC曲线分析,术后第2天△MNV辅助诊断术后感染的AUCROC为0.959;以5.85 fL为cut off值,敏感性为89.7%,特异性为95.5%,优于其他指标。结论术后第2天△MNV对临床监测术后细菌感染有一定价值。Objective To estimate the prognostic value of leucocyte parameters for monitoring postoperative bacterial infection.Methods The peripheral blood samples from healthy controls and the patients with cardiac valve replacement were collected before operation and on the 0,2,3,7 day after operation.The count of white blood cell（WBC）,percentage of neutrophil（N） and mean neutrophil volume（MNV） were measured respectively.The patients complicated with postoperative bacterial infection were compared with those without postoperative infection.The changes of MNV before and after operation,called ΔMNV,were calculated.The receiver-operating characteristics（ROC） curve was analyzed to estimate the possibility of postoperative bacterial infection.Results The values of MNV and △MNV in the infected patients on the second day after operation significantly increased compared with the uninfected patients（t=6.02 and 18.758 respectively,P＆lt;0.01）.There were significant differences of WBC,N,MNV and △MNV between the infected and uninfected patients on the third day after operation（t=5.45,3.51,8.97 and 23.49 respectively,P＆lt;0.01）.On the seventh day after operation,the values of MNV and △MNV of infection patients were increased significantly with statistical differences（t=5.47,12.24,P＆lt;0.01）.By analysis of ROC curve,the AUCROC of △MNV for the auxiliary diagnosis of infection after operation was 0.959.△MNV cut off value of 5.85 fL produced sensitivity of 89.7% and specificity of 95.5%,which was superior to the other leucocyte parameters.Conclusion The △MNV value on the second day after operation may present certain significance for clinical monitoring of postoperative bacterial infection.

关 键 词：中性粒细胞 中性粒细胞体积 术后细菌感染 

分 类 号：R446.1[医药卫生—诊断学]