中性粒细胞百分比及C-反应蛋白在颈部多间隙感染诊断中的应用  

Value of percentage of neutrophils and C-reactive protein in diagnosis of patients with neck multiple interstitial infection

作　　者：张应龙[1] 刘维[1] 龙宇[1] 蒲红[1] 江洪[1] ZHANG Ying-long;LIU Wei;LONG Yu;PU Hong;JIANG Hong(Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院耳鼻咽喉头颈外科

出　　处：《中华医院感染学杂志》2019年第15期2343-2347,共5页Chinese Journal of Nosocomiology

基　　金：重庆市自然科学基金资助项目(2017267)

摘　　要：目的探讨中性粒细胞百分比(Neutrophil percentage,NEU%)、白细胞计数(White blood cell count,WBC)和C-反应蛋白(C-reactive protein,CRP)在颈部多间隙感染患者中的价值。方法收集2016年1月~2018年4月到重庆医科大学附属永川医院治疗的118例颈部多间隙感染患者的临床资料,设为病例组。选取同一时期到医院治疗的100例声带息肉患者作为对照组。采集试验组患者脓液分泌物进行菌株鉴定。在入院治疗前以及治疗后第1、3和6天,采集试验组患者静脉血2ml,检测NEU%、WBC和CRP水平,治疗前后进行组内对比。对照组在入院时做NEU%、WBC和CRP检测,并对两组进行组间比较分析。按照所测的NEU%、WBC和CRP水平在颈部多间隙感染患者中的变化制作出受试者工作特征(Receiver Operating Characteristic,ROC)曲线,分析NEU%、WBC和CRP的截断值、曲线下面积以及灵敏度、特异性和准确度。结果从病例组118例患者标本中共分离得到了136株病原菌,其中革兰阴性菌86株占63.24%、革兰阳性菌46株占33.82%和真菌4株占2.94%;治疗前和治疗后1 d,试验组NEU%和WBC高于对照组(P<0.05);治疗前、治疗后1 d、3 d和6 d,病例组CRP高于对照组(P<0.05);随着治疗的进展,病例组NEU%、WBC和CRP水平均呈下降趋势(P<0.05);以患者入院当天NEU%、WBC和CRP数据为基础进行ROC曲线分析,NEU%、WBC和CRP对颈部多间隙感染的截断值分别为45.60%、9.12×10^9/L和35.56 mg/L,其曲线下面积分别为0.879、0.874和0.981;WBC特异度为85.59%,均高于NEU%的61.86%及CRP的71.19%;CRP灵敏度为84.75%,准确度为87.29%,高于NEU%的77.97%、83.05%和WBC指标的81.36%、77.12%。结论检测颈部多间隙感染患者血液NEU%、WBC和CRP水平动态变化对于评估其病情严重程度和临床诊断具有较高的价值,尤其是CRP对病情发展有更高的敏感性。OBJECTIVE To investigate the value of neutrophil percentage(NEU%),white blood cells(WBC)and C-reactive protein(CRP)in patients with neck multiple interstitial infection.METHODS The clinical data of 118 patients who came to Yongchuan Hospital of Chongqing Medical University for the treatment of neck multiple interstitial infection from Jan.2016 to Apr.2018 were collected,and the patients were selected as the experimental group.100 cases of patients with vocal cord polyps treated in Yongchuan Hospital of Chongqing Medical University during the same period were selected as the control group.The pus secretion specimens of the experimental group were collected,and the pathogens were identified.2 ml of venous blood was collected from the patients with neck multiple interstitial infection in the experimental group before the treatment and 1,3 and 6 days after treatment.NEU%,WBC and CRP levels were detected and compared before and after the treatment.NEU%,WBC and CRP were detected in the control group at admission,and the two groups were comparatively analyzed.Receiver Operating Characteristic(ROC)curves were produced according to the measured changes of NEU%,WBC and CRP levels in patients with neck multiple interstitial infection,and the area under the cure(AUC),cut-off values,sensitivity and specificity of NEU%,WBC and CRP were analyzed.RESULTS A total of 136 strains of pathogens were isolated from the 118 samples,including 86 strains(63.24%)of Gram-negative bacteria,46 strains(33.82%)of Gram-positive bacteria and 4 strains(2.94%)of fungi.The NEU%and WBC in the case group were significantly higher than those of the control group before and 1 d after treatment(P<0.05).The CRP of the case group was significantly higher than that of the control group before and 1 d,3 d and 6 d after treatment(P<0.05).With the progress of treatment,NEU%,WBC and CRP levels in the case group all showed a decreasing trend(P<0.05).Based on the data of NEU%,WBC and CRP on the day of admission,ROC curves were analyzed.The results showed that the

关 键 词：颈部多间隙感染 中性粒细胞百分比 白细胞 C-反应蛋白 诊断 

分 类 号：R782.3[医药卫生—口腔医学]