传统实验室检查项目在鉴别外周血白细胞升高中的应用评价  

The evaluation of traditional laboratory examination in identifying the rise of peripheral blood leukocytes

作　　者：张彦红[1] 王慧[1] 胡轩[1] 袁长友[1] 

机构地区：[1]天津华兴医院内科,天津300270

出　　处：《国际检验医学杂志》2014年第17期2305-2306,共2页International Journal of Laboratory Medicine

摘　　要：目的评价几种实验室检查方法在鉴别糖皮质激素使用与感染造成的白细胞(WBC)升高中的作用。方法收集2011年1月至2012年12月于该院住院治疗的74例患者,根据其病种及治疗方案分为非感染激素组(n=15)、感染非激素组(n=29)和感染激素组(n=30),分别在糖皮质激素和/或抗菌素治疗0、3、7d时采集静脉血,对其外周血C反应蛋白(CRP)、WBC计数、WBC分类计数及中性粒细胞碱性磷酸酶(NAP)积分进行检测,以CRP作为判定有无感染及感染程度的指标,比较其他实验室检查指标的变化情况。结果感染激素组与感染非激素组比较,CRP水平的差异无统计学意义(P>0.05),呈逐渐降低趋势;非感染激素组应用激素3d和7d时与应用激素前进行比较,中性粒细胞计数、NAP积分均显著增高(P<0.01),淋巴细胞计数显著降低(P<0.05),嗜酸性中性粒细胞差异无统计学意义(P>0.05)。结论糖皮质激素与感染造成的外周血WBC升高,无法通过WBC分类计数、WBC升高绝对值及NAP积分进行鉴别。Objective To evaluate the role of several traditional laboratory examinations in identifying the cause of WBC count increase,which might be the adverse reaction of glucocorticoid or infection.Methods 74 patients treated in the hospital from Jan. 2011 to Dec.2012 were recruited in the study.Glucocorticoid without Infection（n =15 ）,Infection without Glucocorticoid（n =29） and Infection with Glucocorticoid（n=30）Group were devided according to the type of disease and therapies.After being treated for 0,3,7 d,respectively venous blood samples of patients were collected to determine the concentration of CRP,WBC count,leukocyte classification and NAP score.CRP was used as the Judgment index for the degree of infection,the changes of other indexes were compared.Results Compared with the Infection without Glucocorticoid Group,the CRP concentration of the Infection with Glu-cocorcoid Group was becoming lower（P 〉0.05）.The Non-infection with Glucocorticoid Group applied glucocorticoid for 3 days and 7 days respectively,the count of neutrophilic granulocyte and NAP score increased significantly compared with that before glucocor-ticoid application（P 〈0.01）while the count of lymphocyte reduced（P 〈0.05）and no significant change in the count of eosnophils （P 〉0.05）.Conclusion The increase of WBC after glucocorticoid can not be identified whether it is the adverse reaction of glu-cocorticoid or aggravated infection by using classification of leukocyte,the increasing amount of WBC and NAP score.

关 键 词：感染 糖皮质激素 C 反应蛋白 中性粒细胞计数 中性粒细胞碱性磷酸酶积分 

分 类 号：R446.1[医药卫生—诊断学]