重症感染后白细胞降低30例临床分析  

Clinical analysis of 30 cases of leukopenia after severe infection

作　　者：希仁娜依·木哈塔尔 丁巍[1] 邬超[1] 杨晓红[1] Xi ren na yi·Mu ha ta cr;DING Wei;WU Chao;YANG Xiao hong(Department of Respiratory and Critical Care Medicine,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院呼吸与危重症医学科

出　　处：《新疆医学》2019年第2期119-122,共4页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区自然科学基金,(项目编号:2015211C214)

摘　　要：目的探讨感染后白细胞降低的临床特点及预后。方法对30例感染后白细胞降低的患者进行临床回顾性分析,同时以30例感染后白细胞升高的病例作为对照组,对炎性指标如外周血白细胞总数(WBC)、中性粒细胞(NE)、降钙素原(PCT)、C-反应蛋白(CRP)、白介素-6(IL-6)统计、分析,并对患者临床特点进行总结。结果实验组与对照组比较,白细胞升高组的PCT、IL-6水平高于白细胞降低组,ROC曲线表示PCT对重症感染后白细胞升高的病例有较高的诊断价值,白细胞降低组的APACHEⅡ评分大于白细胞升高组,白细胞降低组的预后更差。实验组根据白细胞数降低的程度,分为轻度组,中度组,重度组,血清PCT水平比较,重度组>中度组>轻度组,APACHEⅡ评分比较,重度组>中度组>轻度组。予以抗炎治疗后,实验组与对照组白细胞恢复情况未见明显差异,且两组各有20例患者抗炎治疗大于7 d,但白细胞仍未恢复正常。结论目前还尚未发现对重症感染后白细胞降低患者有较高诊断价值的炎性指标,但我们发现实验组白细胞降低程度越高,其预后越差,且PCT水平可能提示其预后。同时实验组与对照组都是大部分患者抗炎治疗大于7 d,白细胞也未能恢复正常。Objective To investigate the clinical characteristics and prognosis of leukopenia after infection. Methods 30 patients with leukopenia after infection were retrospectively analyzed. At the same time, 30 patients with leukopenia after infection were taken as control group. Inflammatory indicators such as WBC, neutrophil(NE), procalcitonin(PCT), C-reactive protein(CRP), interleukin-6(IL-6)were counted and analyzed, and the clinical characteristics of patients were summarized. Results Compared with the control group, the levels of PCT and IL-6 in the leucocyte elevation group were higher than those in the leucocyte reduction group. ROC curve showed that PCT had higher diagnostic value in the cases of leucocyte elevation after severe infection. APACHE Ⅱ score in the leucocyte reduction group was higher than that in the leucocyte elevation group, and the prognosis of the leucocyte reduction group was worse The experimental group was divided into mild group, moderate group, severe group, serum PCT level comparison, severe group > moderate group > mild group, APACHE Ⅱ score comparison, severe group > moderate group > mild group. After anti-inflammatory treatment, there was no significant difference in the recovery of white blood cells between the experimental group and the control group, and 20 patients in each group received anti-inflammatory treatment for more than 7 days, but the white blood cells did not return to normal. Conclusion No inflammatory markers have been found for the diagnosis of leukopenia in patients with severe infection, but we found that the higher the degree of leukopenia in the experimental group, the worse the prognosis, and PCT level may indicate the prognosis. At the same time, most of the patients in the experimental group and the control group were treated with anti-inflammatory therapy for more than 7 days, and the white blood cells did not return to normal.

关 键 词：重症感染 白细胞 

分 类 号：R563.9[医药卫生—呼吸系统]