中性粒细胞/淋巴细胞比值在区分不同病原菌引起血流感染的价值  

Clinical Evaluation on Ratio of Neutrophil-to-Lymphocyte in Different Pathogens

作　　者：任党利[1] 韩海燕[1] 周鑫[1] 刘锦[1] 靳颖[1] 

机构地区：[1]武警后勤学院附属医院检验科,天津300162

出　　处：《现代检验医学杂志》2017年第2期102-105,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨中性粒细胞/淋巴细胞比值(NILR)在区分不同病原菌引起的血流感染及鉴别诊断凝固酶阴性葡萄球菌(CNS)血培养污染中的临床应用价值。方法选取500例同时送检血培养和血常规检查患者资料进行回顾性分析,血培养结果阴性356例,血培养结果阳性144例,根据血培养结果将血培养阳性组分为革兰氏阴性细菌组、革兰氏阳性细菌组、真菌组、CNS污染组以及混合菌感染组。收集血培养结果和计算NLR,采用t检验比较各组细菌NLR水平,采用受试者工作特征曲线(ROC)评价NLR区分不同病原菌引起的血流感染和血培养污染的可能。结果①NLR在血培养阴性组、血培养阳性组、CNS血流感染组和血培养污染组分别为6.12,13.15,10.11和6.24。血培养阴性与阳性组和C;NS血流感染组与血培养污染组之间经统计学分析差异有统计学意义(P均<0.05)。②NLR在革兰氏阴性菌组、革兰氏阳性菌组以及真菌组分别为15.33,11.63和10.58。革兰氏阴性菌组与革兰氏阳性菌组分别与真菌组对比差异无统计学意义(P>0.05),而在区分革兰氏阴性菌组与革兰氏阳性菌组时,差异有统计学意义(P<0.05)。③NLR区分血培养阴性与阳性、革兰氏阴性菌与革兰氏阳性菌、CNS血流感染与血培养污染的曲线下面积分别为0.86,0.60,0.75;最佳截断值分别为10.45,7.50,8.10。结论 NLR对预判血流感染及鉴别诊断CNS引起的血流感染具有较好的应用价值。Objective To investigate the clinical value of neutrophil-to-lymphocyte ratio（NLR） in identifying blood stream in- fection caused by different pathogens and for differentiating coagulase negative staphylococcus（CNS）bloodstream infection and contamination. Methods Medical records of 500 patients who underwent blood culture test and routine blood test at the same time were retrospectively analyzed, blood culture negative group 356 patients, blood culture positive group 144 pa tients,which included Gram-negative group,Gram-positive group,fungi group,CNS bloodstream contamination and mingled group. Collected the results and calculated the NLR at the same time. NLR were applied by t test of each group. ROC curve was used to determine the cut-off value of NLR. Results ①Mean values of NLR in negative blood culture,blood stream in fection group,CNS bloodstream infection and contamination were 6.12,13.15,10. 11 and 6.24. NLR had statistical differ- ence between negative blood culture and blood stream infection group, CNS bloodstream infection group and contamination group （P〈0.05）. ②Mean values of NLR in and fungi group were 15.33,11.63 and 10.58,respectively. NLR had statistical difference between Gram-positive bacteria group and Gram-negative bacteria group （P〈0.05）. NLR had no differences a mong Gram positive bacteria （15.33） and Gram-negative bacteria （11.63） compared with （10.58） fungi respectively （P〈 0.05）. ③The area under the curve of NLR predicting a positive blood culture, distinguishing Gram-positive bacteria and Gram-negative bacteria, differentiating CNS bloodstream infection and contamination were 0.86,0.60 and 0.75, respectively. The optimal cut-off values of NLR for predicting a positive blood culture, distinguishing Gram-positive bacteria and Gram negative bacteria, differentiating CNS bloodstream infection and contamination were 10.45,7.50 and 8. 10 respectively. Con- clusion NLR is highly effective in distinguishing blood stream infection and differentiating C

关 键 词：中性粒细胞/淋巴细胞比值 血流感染 血培养污染 

分 类 号：R515[医药卫生—内科学] R446.111[医药卫生—临床医学]