血嗜酸性粒细胞在新型冠状病毒感染确诊病例与疑似病例中的识别及启示  

The recognition and revelation of eosinophils between confirmed and suspected cases of 2019-nCoV

作　　者：陈娟娟[1] 姚明解 王彦芳[1] 苏佩 王松[1] CHEN Juan-juan;YAO Ming-jie;WANG Yan-fang(Department of Pharmacy,First Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院药学部,河南郑州450052 [2]北京大学基础医学院人体解剖学与组织胚胎学系,北京100191

出　　处：《医学检验与临床》2022年第5期20-23,38,共5页Medical Laboratory Science and Clinics

基　　金：郑州大学第一附属医院院内青年创新基金项目,项目编号:15110502。

摘　　要：目的:探索血嗜酸性粒细胞对新型冠状病毒感染疑似病例与确诊病例的区分价值。方法:回顾性收集于2020年1月~2020年2月期间,在郑州大学第一附属医院入院就诊的22例新型冠状病毒肺炎确诊病例及25例新型冠状病毒肺炎疑似病例的临床信息,使用受试者工作特征曲线(ROC)进行统计学分析。结果分析结果表明疑似病例与确诊病例C反应蛋白、白细胞计数、淋巴细胞水平差异均无统计学意义,在疑似病例与确诊病例中均出现C反映蛋白升高现象,异常率分别为76.2%、76%,两组差异无统计学意义(P=0.988);在疑似病例与确诊病例中白细胞降低的比例分别为8%、22.7%,升高比例分别为8%、22.7%,正常比例占84%、54.5%,差异无统计学意义(P=0.084)。嗜酸性粒细胞、凝血酶原时间、谷草转氨酶、乳酸脱氢酶水平差异有统计学意义。其中嗜酸性粒细胞差异最为明显中位数,疑似病例:0.10(0.06~0.12)×10^(9)/L,确诊病例:0.00(0.00~0.03)×10^(9)/L,P<0.0001,疑似病例与确诊病例的异常率分别为0%与59.1%。血嗜酸性粒细胞用于诊断新冠肺炎确诊病例的cut-off值为0.04×10^(9)/L,相应的AUROC为0.917(95%CI:0.799~0.978),敏感性为81.82%,特异性为84.00%。结论血嗜酸性粒细胞在疑似病例中区分确诊病例有良好的敏感性和特异性,可以作为在疑似病例中区分确诊病例的重要辅助手段,在临床上应引起关注。Objective:To explore the value of eosinophil in distinguishing suspected and confirmed cases of novel coronavirus infection.Methods:The study retrospectively collected clinical information of 22 patients with confirmed new coronavirus pneumonia and 25 patients with suspected new coronavirus pneumonia admitted to the first affiliated hospital of Zhengzhou university between January 2020 and February 2020,and subject operating characteristic curve(ROC)was used for statistical analysis.Results:The analysis results showed that there were no statistically significant differences in C-reactive protein(CRP),white blood cell count and lymphocyte levels between the suspected and confirmed patients,and CRP was increased in both the suspected and confirmed patients,with an abnormal rate of 76.2%and 76%,respectively.There was no statistically significant difference between the two groups(P=0.988).In the suspected and confirmed cases,the proportion of decreased white blood cells was 8%,22.7%,increased 8%,22.7%,normal 84%and 54.5%,respectively,and the difference was not statistically significant.The levels of eosinophil,prothrombin time,transaminase and lactate dehydrogenase were significantly different.The most obvious difference of eosinophil median,patients with suspected:0.10(0.06~0.12)×10^(9)/L,diagnosed patients:0.00(0.00~0.03)×10^(9)/L,P<0.0001,patients with suspected patients with diagnosis of abnormal rate was 0%and 59.1%,respectively.The blood eosinophil for new crown pneumonia patients with confirmed diagnosis of the cut off value of 0.04×10^(9)/L,the corresponding AUROC was 0.917 95%CI:The sensitivity was 81.82%and the specificity was 84.00%.Conclusions:Blood eosinophils have good sensitivity and specificity in distinguishing confirmed cases from suspected cases,and can be used as an important auxiliary means to distinguish confirmed cases in suspected cases,which should be paid attention to clinically.

关 键 词：新型冠状病毒 嗜酸性粒细胞 确诊病例 疑似病例 

分 类 号：R73[医药卫生—肿瘤]