未成熟中性粒细胞计数联合PCT在烧伤细菌感染诊断中的价值  

Value of Immature Neutrophils Combined with PCT in Diagnosis of Bacterial Infection in Burns

作　　者：刘婧 赵权 楚健怡 陈嘉彦 毕伟建 LIU Jing;ZHAO Quan;CHU Jianyi;CHEN Jiayan;BI Weijian(People’s Liberation Army Navy 971 Hospital,Qingdao 266000,China;Shanghai Fourth People’s Hospital,Shanghai 200080,China)

机构地区：[1]中国人民解放军海军第971医院,山东青岛266000 [2]上海市第四人民医院,上海200080

出　　处：《北华大学学报（自然科学版）》2023年第6期779-782,共4页Journal of Beihua University（Natural Science）

基　　金：上海市虹口区健康委员会医学科研课题项目(2021-07)。

摘　　要：目的 探讨未成熟中性粒细胞比例(IG%)、未成熟中性粒细胞计数(IG#)、白细胞计数(WBC)、中性粒细胞比例(Neut)及降钙素原(PCT)对烧伤患者细菌感染的诊断价值.方法 回顾性分析91例中重度烧伤患者的临床和实验室资料,按照是否感染分为感染组(33例)和无感染组(58例),再选取同期体检的40名健康体检者为对照组.比较3组参与者的WBC、Neut、PCT、IG、IG#水平,二分类回归分析烧伤患者发生感染的预测概率函数,绘制受试者工作曲线(ROC),评价各项感染指标及感染预测函数诊断烧伤感染的诊断效能.结果 3组参与者的5种感染指标之间比较差异均具有统计学意义(P<0.05).两两比较,感染组各指标均显著高于无感染组和对照组(P<0.05).无感染组WBC、Neut及IG均显著高于对照组(P<0.05),而两组IG#比较差异无统计学意义(P>0.05).二分类回归分析纳入烧伤诊断的指标有PCT和IG#.5项指标中,PCT单独诊断烧伤细菌感染的诊断效率最高,AUC为0.877,敏感度为84.85%,特异度为87.93%,约登指数为0.728.PCT和IG#联合诊断效率优于PCT,其AUC为0.924,敏感度为87.88%,特异度为89.66%,约登指数为0.775.结论 IG#是烧伤细菌感染诊断的潜在生物标记物,且IG#联合PCT对烧伤感染的诊断效率优于IG#、 PCT的单独指标.Objective To study the diagnostic value of immature neutrophil ratio(IG%),IG count(IG#),white blood cell(WBC),neutrophil ratio(Neut) and procalcitonin(PCT) in burn patients with bacterial infection.Method The clinical and laboratory data of 91 patients with moderate,severe burns were retrospectively analyzed.According to the infection or not,the patients were divided into infection group(33 cases) and uninfected group(58 cases).40 cases of health examination during the same period were selected as control group.The levels of WBC,Neut,PCT,IG and IG# were compared among the three groups.The predictive probability function of infection in burn patients was analyzed by binary regression analysis.Receiver Operator Characteristic(ROC) was drawn to evaluate the diagnostic efficacy of infection indicators and infection predictive function in the diagnosis of burn infection.Results There were significant differences among the five infection indicators of the three groups(P<0.05).Compared with the control group and the non-infected group,each index of the infected group was significantly higher than that of the non-infected group(P<0.05).WBC,Neut and IG in the non-infected group were significantly higher than those in the control group(P<0.05),but there was no significant difference in IG# between the two groups(P>0.05).PCT and IG# were included in the binary regression analysis.Among the five indicators,PCT alone had the highest diagnostic efficiency for burn bacterial infection,with AUC of 0.877,sensitivity of 84.85%,specificity of 87.93%,and Yoden index of 0.728.The combined diagnostic efficiency of PCT and IG# was better than that of PCT,AUC was 0.924,the sensitivity was 87.88%,the specificity was 89.66%,and the Yoden index was 0.775.Conclusion IG# is a potential biomarker for the diagnosis of bacterial infection in burns,and the diagnostic efficiency of IG# combined with PCT is better than that of IG# and PCT as single index respectively,which is worthy of further study.

关 键 词：未成熟中性粒细胞 降钙素原 烧伤感染 联合诊断 

分 类 号：R644[医药卫生—外科学]