MNV与PCT在脑出血昏迷患者并发败血症中的诊断性能分析  

The Diagnostic Value of MNV in Cerebral Hemorrhage Coma Patients with Septicemia

作　　者：李新玲[1] 曹兴建[2] 朱易华[2] 范玉平[2] 杨屹[3] 

机构地区：[1]南通市第一人民医院神经内科,江苏南通226001 [2]南通市第一人民医院检验科,江苏南通226001 [3]南通大学杏林学院,江苏南通226001

出　　处：《标记免疫分析与临床》2015年第11期1082-1085,共4页Labeled Immunoassays and Clinical Medicine

基　　金：南通市卫生局青年基金支持(WQ2014011)

摘　　要：目的分析中性粒细胞体积参数(mean neutrophil volume,MNV)在机体应激状态时的变化,探讨其诊断脑出血昏迷患者并发败血症的可能。方法使用Coulter LH 750血液分析仪,检测51例经细菌培养确诊并发感染者和52例无感染症状者及300例正常对照者的外周血,记录白细胞计数(white blood cell,WBC)、中性粒细胞(neutrophil,NE)和中性粒细胞体积参数,再进行指标的组间比较分析。结果无症状组、局限感染组、败血症组3组入院WBC、NE、MNV和降钙素原(procalcitonin,PCT)结果差异无统计学意义(P>0.05),且众所周知,创伤应激状态下,3组WBC、NE和MNV均高于健康人对照组(P<0.05)。出现感染症状时MNV及PCT在两感染组间都出现了显著性变化(P<0.01),而WBC、中性粒细胞百分数(NE%)未出现显著性差异(P>0.05)。败血症期MNV与PCT具有较好的相关性(r=0.802,P<0.05)。感染期鉴别诊断败血症时,MNV和PCT的ROC曲线下面积分别为0.865、0.883,要大于其他指标;在取临界值≥155.28 f L和≥13.1mg/L时,敏感性为90.65%和85.32%,特异性为87.34%和92.17%。结论继发的细菌感染引起了应激状态下中性粒细胞MNV参数的显著性变化,其对临床诊治脑出血昏迷患者并发败血症有一定帮助。Objective To investigate the diagnostic value of mean neutrophil volume for postoperative septicemia in cerebral hemorrhage coma patients. Methods The 52 cases of cerebral hemorrhage coma patients without infection,51 cases of patients with infection and 300 health controls were involved in this study. The peripheral blood samples from patients and controls were collected before hospitalization and on the infection period,and the count of white blood cell（ WBC）,percentage of neutrophil（ NE）,mean neutrophil volume（ MNV） and PCT were detected respectively. The receiver-operating characteristics（ ROC） curve was analyzed to estimate the possibility of septicemia. Results The values of WBC,NE and MNV in the infected patients before hospitalization had not significantly differences compared with the uninfected patients（ P〉 0. 05）,but these values in stringent state were higher than that of healthy controls（ P〈 0. 05）. There were significant differences on MNV and PCT between the infected and uninfected patients in the infection period（ P〈 0. 01）,but there was not significant differences on WBC and NE%（ P 〈0. 05）. There was a good correlation between MNV and PCT in septicemia patient（ r = 0. 802,P〈 0. 05）. The ROC curve indicated that the AUCROCof MNV and PCT for the auxiliary diagnosis of septicemia was 0. 865 and 0. 883. The MNV cutoff of 155. 28 and PCT cutoff of13. 1 produced 90. 65% and 85. 32% sensitivity,and 87. 34% and 92. 17% specificity respectively,which was superior to the other leucocytes parameters. Conclusion The MNV value may present certain significance for clinical monitoring of septicemia in cerebral hemorrhage coma patients.

关 键 词：败血症 中性粒细胞体积参数 脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R515.3[医药卫生—临床医学]