NLR、PCT、CRP联合检测对早期COVID-19的诊断价值  

Early diagnosis value of NLR,PCT and CRP combined determination for COVID-19

作　　者：朱传新 周玉平 周琴 周桂凤 ZHU Chuanxin;ZHOU Yuping;ZHOU Qin;ZHOU Guifeng(Department of Clinical Laboratory,Xianning First People's Hospital,Xianning 437000,Hubei,China;Department of Cardiology,Xianning First People's Hospital,Xianning 437000,Hubei,China;Department of Nephrology,Xianning First People's Hospital,Xianning 437000,Hubei,China)

机构地区：[1]咸宁市第一人民医院检验科,湖北咸宁437000 [2]咸宁市第一人民医院心血管内科,湖北咸宁437000 [3]咸宁市第一人民医院肾内科,湖北咸宁437000

出　　处：《检验医学》2021年第1期53-56,共4页Laboratory Medicine

摘　　要：目的探讨中性粒细胞/淋巴细胞比值(NLR)、降钙素原(PCT)和C反应蛋白(CRP)对早期新型冠状病毒肺炎(COVID-19)的诊断价值。方法选取咸宁市第一人民医院230例疑似COVID-19患者,根据胸部电子计算机断层扫描(CT)、严重急性呼吸综合征冠状病毒2(SARS-CoV-2)核酸、病毒血清学抗体和血培养检测结果将患者分为COVID-19组(80例)、感冒组(100例)和细菌组(50例),比较3个组白细胞(WBC)计数、中性粒细胞绝对数(NEUT#)、淋巴细胞绝对数(LYMPH#)、淋巴细胞百分比(LYMPH%)、嗜酸性粒细胞绝对数(EO#)、NLR、PCT、CRP水平。结果与感冒组相比,COVID-19组NLR、CRP水平较高,LYMPH%、LYMPH#、EO#水平较低,差异有统计学意义(P<0.05)。与细菌组相比,COVID-19组LYMPH#、EO#、NEUT#、PCT、WBC计数较低,差异有统计学意义(P<0.05)。对3个组患者分层比例进行比较发现,与感冒组相比,COVID-19组患者WBC计数<4.00×109/L、LYMPH#<0.80×109/L、LYMPH%<20%、EO#<0.05×109/L、NLR>3.0、CRP≥10.00 mg/L比例较高,差异有统计学意义(P<0.05);与细菌组相比,COVID-19组患者WBC计数<4.00×109/L、NEUT#<2.00×109/L、LYMPH#<0.80×109/L、EO#<0.05×109/L比例较高,WBC计数>10.00×109/L、NEUT#>7.00×109/L、EO#>0.50×109/L、PCT≥0.50 ng/mL比例较低,差异有统计学意义(P<0.05)。结论LYMPH#减少、PCT正常、NLR和CRP增高是COVID-19早期标志,联合检测可作为SARS-CoV-2核酸检测的补充。Objective To investigate the value of neutrophil/lymphocyte ratio(NLR),procalcitonin(PCT)and C-reactive protein(CRP)determinations in the early diagnosis of corona virus disease 2019(COVID-19).Methods A total of 230 suspected COVID-19 patients were enrolled and classified into COVID-19 group(80 cases),cold group(100 cases)and bacterial group(50 cases)according to thorax computed tomography(CT),severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid,viral serological antibody and blood culture results.The levels of white blood cell(WBC)count,the absolute value of neutrophil(NEUT#),the absolute value of lymphocyte(LYMPH#),the percentage of lymphocyte(LYMPH%),the absolute value of easinosphils(EO#),NLR,PCT and CRP among the 3 groups were compared.Results Compared with cold group,COVID-19 group had higher levels of NLR and CRP,and the levels of LYMPH%,LYMPH#and EO#were lower(P<0.05).Compared with bacterial group,COVID-19 group had lower levels of LYMPH#,EO#,NEUT#,PCT and WBC count(P<0.05).Compared with cold group,COVID-19 group had higher proportions of WBC count<4.00,LYMPH#<0.80,LYMPH%<20%,EO#<0.05,NLR>3.0 and CRP≥10.00(P<0.05).Compared with bacterial group,COVID-19 group had higher proportions of WBC count<4.00,NEUT#<2.00,LYMPH#<0.80 and EO#<0.05(P<0.05)and lower proportions of WBC count>10.00,NEUT#>7.00,EO#>0.50,PCT≥0.50(P<0.05).Conclusions Decreased LYMPH#,normal PCT and increased NLR and CRP are early markers of COVID-19 patients.The combined determination can be used as a supplement to SARS-CoV-2 nucleic acid determination.

关 键 词：新型冠状病毒肺炎 淋巴细胞绝对数 中性粒细胞/淋巴细胞比值 降钙素原 C反应蛋白 

分 类 号：R446.1[医药卫生—诊断学]