新型冠状病毒感染诱导冷凝集现象对血常规参数的影响  

Influence on blood routine parameters of severe acute respiratory syndrome coronavirus 2 infection induced cold condensation aggregation

作　　者：朱名超[1] 朱娅[2] 郭飞波 黄银娥[1] Zhu Mingchao;Zhu Ya;Guo Feibo;Huang Yine(Department of Clinical Laboratory,the First People’s Hospital of Tianmen City,Tianmen 431700,China;Department of Neurology,the First People’s Hospital of Tianmen City,Tianmen 431700,China)

机构地区：[1]天门市第一人民医院检验科,天门市431700 [2]天门市第一人民医院神经内科,天门市431700

出　　处：《中华实验和临床感染病杂志（电子版）》2023年第4期244-251,共8页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：中央高校基本科研业务费专项基金(No.2042020kfxg05);深圳市科技计划项目(No.JSGG 20200225152911537)。

摘　　要：目的探讨新型冠状病毒(SARS-CoV-2)感染导致冷凝集现象对血常规参数的影响,以及37℃温育30 min纠正后的效果,以提高血常规检测结果的准确性。方法收集天门市第一人民医院2022年12月26日~2023年1月17日SARS-CoV-2感染者血常规标本2875例为COVID-19组,同期SARS-CoV-2核酸阴性的流感患者50例为对照组;同时选取2022年8月~11月SARS-CoV-2核酸阴性的所有住院患者血常规标本28072例为非COVID-19组,COVID-19组患者又进一步分为冷凝集组(54例)和无冷凝集组(2821例),COVID-19组再分为轻型、中型、重型、危重型4组;根据MCHC结果将冷凝集组分为强冷凝集组(>380 g/L)(32例)和弱冷凝集组(≤380 g/L)(22例),采用37℃温育方法纠正处理冷凝集标本,对比纠正前后各型各组血常规各参数的变化。结果COVID-19组[1.88%(54/2875)]与非COVID-19组患者冷凝集率[0.071%(20/28072)]差异有统计学意义(χ^(2)=356.97、P<0.001),COVID-19组与非COVID-19组患者白细胞(WBC)、红细胞(RBC)、血红蛋白(HGB)、血细胞比容(HCT)和血小板(PLT)差异均无统计学意义(Z=-1.680、P=0.093,t=1.376、P=0.185,t=1.069、P=0.299,t=1.127、P=0.274,Z=-0.532、P=0.601);平均红细胞血红蛋白含量(MCH)、红细胞平均体积(MCV)和平均血红蛋白浓度MCV(MCHC)差异有统计学意义(t=-3.194、P=0.005,Z=-3.622、P<0.001,Z=-2.435、P=0.015);COVID-19组轻型、中型、重型和危重型患者冷凝集率分别为0.18%(4/2242)、3.96%(18/455)、17.88%(27/151)和18.52%(5/27),差异有统计学意义(Z=260.40、P<0.001),中型与轻型、重型与轻型、危重型与轻型以及重型与中型患者组间两两比较差异均有统计学意义(χ^(2)=97.97、18.87、20.66、93.85,P均<0.001);危重型与中型、重型与危重型患者差异均无统计学意义(χ^(2)=3.068、P=0.08,χ^(2)=1.06、P=0.937)。冷凝集组标本经37℃温育30 min均得以纠正,纠正前后WBC、RBC、HCT、MCV、MCH和MCHC差异均有统计学意义(Z=-4.953、t=10.137、t=8.6Objective To investigate the influence of cold agglutination caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection on routine blood parameters and the effect of 30 min correction at 37℃,and to improve the accuracy of routine blood test results.Methods From December 26th,2022 to January 17th,2023,a total of 2875 blood routine samples of patients infected with SARS-CoV-2 were collected from the First People’s Hospital of Tianmen,which were classified as the coronavirus disease 2019(COVID-19)group.Total of 50 influenza patients with SARS-CoV-2 nucleic acid negative were selected as the control group,while 28072 inpatients with SARS-CoV-2 nucleic acid negative were selected as the non-COVID-19 group from August to November 2022,and the COVID-19 group was further divided into the cold agglutination group(54 cases)and the non-cold agglutination group(2821 cases).The COVID-19 group was divided into four groups:light,medium,severe and critical groups.According to the mean corpuscularhemoglobin concentration(MCHC)results,the cold agglutination group was divided into the strong cold agglutination group(>380 g/L)(32 cases)and the weak cold agglutination group(≤380 g/L)(22 cases).The cold agglutination specimens were warmed at 37℃,and the changes of blood routine parameters in each group before and after the correction were compared.Results The cold agglutination rate of the COVID-19 infected group was 1.88%(54/2875)compared with that of the non-COVID-19 group[0.071%(20/28072)],the difference was statistically significant(χ^(2)=356.97,P<0.001).There were no significant differences in white blood cell(WBC),red blood cell(RBC),hemoglobin(HGB),hematocrit(HCT)and platelet(PLT)between COVID-19 infected patients and non-COVID-19 infected patients(Z=-1.680,t=1.376,t=1.069,t=1.127,Z=-0.532;P=0.093,0.185,0.299,0.274,0.601);The differences of mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH)and MCHC were statistically significant(t=-3.194,Z=-3.622,-2.435;P=0.005,<0.001,0.015).The incidence

关 键 词：新型冠状病毒 冷凝集 平均血红蛋白浓度 红细胞 血小板 温育法 

分 类 号：R563.1[医药卫生—呼吸系统]