未成熟粒细胞计数在全身炎症反应综合征诊断与预后观察中的应用  

Application of immature granulocyte count in the diagnosis and the assessment of prognosis of systemic inflammatory response syndrome

作　　者：许青[1] 陈保德[1] 潘巍[2] 徐卫益[1] 

机构地区：[1]浙江大学医学院附属第一医院检验科,浙江杭州310003 [2]绍兴文理学院检验教研室,浙江绍兴312000

出　　处：《国际检验医学杂志》2015年第16期2369-2370,2374,共3页International Journal of Laboratory Medicine

摘　　要：目的评价未成熟粒细胞(IG)计数在全身炎症反应综合征(SIRS)中的诊断价值及预后观察,为SIRS的诊断和疾病的预后提供新的检验指标。方法选取易引起SIRS的患者207例,连续监测其IG动态变化与疾病进展的情况。采集EDTA-2K抗凝血标本,用Sysmex XE-2100血液分析仪进行全血细胞计数和IG计数,同时测定C-反应蛋白(CRP)和前降钙素原(PCT)。利用受试者工作特征曲线(ROC曲线)分析并计算曲线下面积(AUC),确定各参数用于诊断的灵敏度和特异度。并连续观察同一患者三项指标的动态变化与临床表现的情况。结果将IG绝对计数IG#>0.165定为诊断SIRS的cut-off值,AUC为0.78,灵敏度为62.2%,特异度为73%;IG相对计数IG%>2.55%时,AUC为0.771,灵敏度为54.1%,特异度为94.6%;CRP>64.15mg/L定为阈值,AUC为0.716,灵敏度为67.6%,特异度为75.7%;PCT>0.33mg/L定为阈值,AUC为0.772,灵敏度为75.7%,特异度为70.3%。结论 IG计数在全身炎症反应综合征中的诊断及预后观察中有较好的应用价值。Objective To evaluate the value of immature granulocytes count in diagnosing and monitoring the systemic inflammatory response for patients with systemic inflammatory response syndrome,and to provide a new indicator of systemic inflammatory response.Methods 207 patients suspected of systemic inflammatory response syndrome were enrolled.The dynamic changes of immature granulocytes counts and the disease situation were recorded for all subjects.The blood samples were collected in vacuum tubes with EDTA-K2 anticoagulant.Blood cell count and immature granulocytes count were performed in Sysmex XE-2100 hematology analyzer.The determination of C-reactive protein and procalcitonin were also completed.The performance of immature granulocytes in diagnosing systemic inflammatory response syndrome was evaluated by receiver operating characteristic curve analysis. Results The area under the curve of immature granulocyte count （IG ）was 0.78 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 62.2 % and a specificity of 73 % at IG 〉 0.1 65.The area under the curve of immature granulocyte percent （IG%）was 0.771 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 54.1 % and a specificity of 94.6 % at IG%〉2.55 %.The area under the curve of C-reactive protein was 0.71 6 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 67.6% and a specificity of 75.7 % at C-reactive protein〉 64.15 mg/L.The area under the curve of procalcitonin was 0.772 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 75.7 % and a specificity of 70.3 % at procalcitonin〉 0.33 mg/L.Conclusion Immature granulocyte count is beneficial for the diagnosis and the assessment of prognosis of systemic inflammatory response syndrome.

关 键 词：未成熟粒细胞 全身炎症反应综合征 C-反应蛋白 前降钙素原 

分 类 号：R459.7[医药卫生—急诊医学]