中性粒细胞delta指数在化脓性关节炎与痛风性关节炎急性发作期早期诊断中的临床意义  

Clinical significance of delta neutrophil index in the early diagnosis of pyogenic arthritis and acute gout attack

作　　者：马铭[1] 任汉强[1] MA Ming;REN Han-qiang(Department of Orthopaedics,the affiliated Hospital of Jianghan University ( Sixth Hospital of Wuhan ) Wuhan,Hubei,430015,China)

机构地区：[1]江汉大学附属医院内分泌科,武汉430015

出　　处：《中国骨与关节杂志》2018年第12期907-911,共5页Chinese Journal of Bone and Joint

摘　　要：目的探讨中性粒细胞delta指数(delta neutrophil index,DNI)在化脓性关节炎与痛风性关节炎急性发作期患者中早期诊断的临床意义。方法回顾分析2015年1月至2017年12月,在我院接受治疗的80例痛风关节炎急性发作期(痛风急性发作组)和60例化脓性关节炎(化脓性关节炎组)患者的临床资料。比较两组患者在临床特征方面的差异。利用受试者工作特征曲线(ROC曲线)分析不同指标在鉴别化脓性关节炎与痛风性关节炎急性发作期发作中的诊断价值。采用单因素、多因素Logistic回归分析评价不同指标在化脓性关节炎与痛风性关节炎急性发作期发作中的预测价值。结果白细胞计数:痛风急性发作组(9.15±2.88)化脓性关节炎组(11.33±3.02)(P<0.01);DNI:痛风急性发作组(0.77±0.25)%,化脓性关节炎组(4.02±1.25)%,(P<0.01);红细胞沉降率:痛风急性发作组(60.25±25.24) mm/h,化脓性关节炎组(75.61±23.44) mm/h,(P<0.01);C-反应蛋白:痛风急性发作组(81.27±24.31) mg/L,化脓性关节炎组(118.64±30.55)(P<0.01);尿素氮:痛风急性发作组(350.26±26.52) mg/L,化脓性关节炎组(200.71±19.47) mg/L,(P<0.01);肌酐:痛风急性发作组(20.02±4.03) mg/L,化脓性关节炎组(10.14±2.12) mg/L,(P<0.01);尿酸:痛风急性发作组(80.22±10.26) mg/L,化脓性关节炎组(30.57±6.33) mg/L,(P<0.01)。鉴别化脓性关节炎与痛风性关节炎急性发作期发作的最佳诊断界值为:白细胞计数11.20×103/mm3、DNI 2.00%、红细胞沉降率68.50 mm/h、C-反应蛋白105.25 mg/L、尿素氮290.15 mg/L、肌酐17.75 mg/L、尿酸60.50 mg/L。多因素Logistic回归分析显示,DNI≥2.00%、红细胞沉降率≥68.50 mm/h、C-反应蛋白≥105.25 mg/L是预测化脓性关节炎的重要参数(P<0.05),尿酸≥60.50 mg/L是预测痛风性关节炎急性发作期的重要参数(P<0.05)。结论 DNI是除红细胞沉降率、C-反应蛋白、尿酸指标外早期鉴别化脓性关节炎与痛风性关节炎急性发作期患�Objective To investigate the clinical significance of delta neutrophil index (DNI)in the early diagnosis of pyogenic arthritis and acute gout attack. Methods Eighty patients with acute gout attack (acute gout attack group)and 60 patients with pyogenic arthritis (pyogenic arthritis group)in our hospital from Jan 2015 to Dec 2017 were selected as study subjects. Clinical differences between the 2 groups were compared. ROC curve was applied to analyze the different indexes. Single factor and multi-factor Logistic regression analysis was used to evaluate the predictive value of different indexes in pyogenic arthritis and acute gout attack. Results Leukocyte count: (9.15±2.88)in the acute gout attack group; (11.33±3.02)in the pyogenic arthritis group; (P<0.01). DNI: (0.77±0.25)% in the acute gout attack group; (4.02±1.25)% in the pyogenic arthritis group; (P<0.01). Erythrocyte sedimentation rate: (60.25±25.24)mm/h in the acute gout attack group; (75.61±23.44)mm/h in the pyogenic arthritis group; (P<0.01). Creactive protein: (81.27±24.31)mg/L in the gout acute attack group; (118.64±30.55)in the pyogenic arthritis group; (P<0.01). Urea nitrogen: (350.26±26.52)mg/L in the acute gout attack group; (200.71±19.47)mg/L in the pyogenic arthritis group; (P<0.01). Creatinine: (20.02±4.03)mg/L in the acute gout attack group; (10.14±2.12)mg/L in the pyogenic arthritis group; (P<0.01). Uric acid: (80.22±10.26)mg/L in the acute gout attack group; (30.57±6.33)mg/L in the pyogenic arthritis group; (P<0.01). The optimal cutoff value of DNI, white blood cell count, erythrocyte sedimentation rate, C-reactive protein, urea nitrogen, creatinine and uric acid in differentiating pyogenic arthritis and acute gout attack were 11.20 × 10^3/mm^3 , 2.00%, 68.50 mm/h, 105.25 mg/L, 290.15 mg/L, 17.75 mg/L, 60.50 mg/L, respectively. Multivariate Logistic regression analysis showed that DNI ≥ 2.00%, erythrocyte sedimentation rate ≥ 68.50 mm/h, C-reaction protein ≥ 105.25 mg/L were important parameters to predict pyogenic arthrit

关 键 词：关节炎 痛风性 关节炎 感染性 早期诊断 关节炎 化脓性 中性粒细胞指数 

分 类 号：R684.3[医药卫生—骨科学]