新型冠状病毒肺炎影像学与实验室多指标分析  

An Analysis of Novel Coronavirus Pneumonia Imaging and Laboratory Multi-Parameter Indexes

作　　者：左晓娜[1] 齐发梅[2] 曲红光[1] 张雅军 范强 ZUO Xiaona;QI Famei;QU Hongguang;ZHANG Yajun;FAN Qiang(Department of Radiology,Gansu Province People Hospital,Lanzhou 730000,China;Department of Laboratory,Gansu Province People Hospital,Lanzhou 730000,China;Honggu Branch Hospital,Gansu Province People Hospital,Lanzhou 730000,China;Xigu District Hospital,Lanzhou 730060,China)

机构地区：[1]甘肃省人民医院放射科,甘肃兰州730000 [2]甘肃省人民医院检验科,甘肃兰州730000 [3]甘肃省人民医院红古分院放射科,甘肃兰州730080 [4]甘肃省兰州市西固区医院检验科,甘肃兰州730060

出　　处：《标记免疫分析与临床》2021年第5期801-804,共4页Labeled Immunoassays and Clinical Medicine

基　　金：甘肃省人民医院院内科研支持项目(编号:17GSSY1-6)。

摘　　要：目的探讨实验室多指标在新冠肺炎患者不同核酸检测与肺部影像学改变组间是否存在差异。方法收集我院及西固区医院2020年1至3月定点隔离的患者61例,所有患者住院期间均进行核酸检测、胸部CT检查,收集患者初次检测的白细胞计数、淋巴细胞计数、C反应蛋白(CRP)、白介素-6(IL-6)、血清降钙素原(PCT)、乳酸脱氢酶(LDH)和尿酸指标,并分为核酸阳性CT肺炎组、核酸阳性CT无肺炎组、核酸阴性CT肺炎组和核酸阴性CT无肺炎组。分析4组患者7个实验室检测指标的差异性,分别绘制各实验室指标的受试者工作特征曲线(ROC曲线),根据曲线下面积(AUC)和最佳临床临界值来分别评价各实验室指标的诊断价值及其诊断的灵敏度和特异性。结果4组间的淋巴细胞计数、CRP、IL6、PCT、LDH、尿酸差异均存在统计学意义(P<0.05)。7项实验室指标诊断效能由大到依次为CRP、IL-6、PCT、LDH、淋巴细胞计数、白细胞计数、尿酸,灵敏度依次为LDH、白细胞计数、尿酸、淋巴细胞计数、CRP、IL-6、PCT,特异性依次为PCT、CRP、IL-6、淋巴细胞计数、LHD、白细胞计数、尿酸。结论核酸阳性CT肺炎组的淋巴细胞计数最低,LHD最高。核酸阴性CT肺炎组的CRP、IL-6明显高于核酸阳性CT肺炎组。实验室指标CRP、IL-6、淋巴细胞计数对新冠肺炎具有鉴别诊断价值。Objective To investigate whether there are differences in the laboratory multi-parame-ter indicators between different nucleic acid detection and pulmonary imaging changes in patients with novel coronavirus pneumonia(NCP).Methods We collected 61 cases isolated patients from our hospital and Xigu District Hospital from January to March in 2020.All patients underwent nucleic acid testing and chest CT examination during hospitalization,and we also collected the white blood cell count,lymphocyte count,CRP(C-reactive protein),IL-6(interleukin-6),PCT(procalcitonin),LDH(lactate dehydrogenase)and uric acid indictors of the patients for the first test results.All patients were then divided into the nucleic acid positive CT pneumonia group,nucleic acid positive CT no pneumonia group,nucleic acid negative CT pneumonia group and nucleic acid negative CT no pneumonia group.Seven experiments were analyzed among four groups of patients for the difference of laboratory parameter indicators.We drew the receiver operating characteristic curve(ROC curve)of each laboratory parameter indicators respectively,and evaluated the diagnosis value,the sensitivity and specificity of each laboratory parameter indicators according to the area under the curve(AUC)and identified the best clinical critical value.Results There were statistical differences in lymphocyte count,CRP,IL-6,PCT,LDH and uric acid among the four groups(P<0.05).The diagnostic efficiencies of seven laboratory parameter indicators from high to low were:CRP,IL-6,PCT,LDH,lymphocyte count,white blood cell count,and uric acid,and LDH,white blood cell count,uric acid,lymphocyte count,CRP,IL-6,and PCT for sensitivity,while PCT,CRP,IL-6,lymphocyte count,LDH,white blood cell count,and uric acid for specificity.Conclusion Lymphocyte count is the lowest,and LDH is the highest in the nucleic acid positive CT pneumonia group.CRP and IL-6 are the highest in the nucleic acid negative CT pneumonia group.Lymphocyte count,CRP,IL-6 and LDH can be used for the diagnosis in NCP and differential

关 键 词：新冠肺炎 X计算机体层成像 实验室指标 

分 类 号：R563[医药卫生—呼吸系统]