细菌性肺炎患儿外周血细胞计数、形态学检查及其与感染程度的相关性分析  

Correlation analysis of peripheral blood cell count and morphological examination with infection degree in children with bacterial pneumonia

作　　者：陈利蜜 崔宇晖 马海鹏 张志刚 孟冰 CHEN Limi;CUI Yuhui;MA Haipeng;ZHANG Zhigang;MENG Bing(Laboratory Department,Handan First Hospital,Handan,Hebei 056000,China;Department of Ophthalmology,Handan Third Hospital,Handan,Hebei 056001,China;Department of Pathology,Wei County People's Hospital,Handan,Hebei 056800,China)

机构地区：[1]邯郸市第一医院检验科,河北邯郸056000 [2]邯郸市第三医院眼科,河北邯郸056001 [3]魏县人民医院病理科,河北邯郸056800

出　　处：《临床肺科杂志》2024年第4期555-560,共6页Journal of Clinical Pulmonary Medicine

基　　金：邯郸市科学技术研究与发展计划项目(No.21422083047)。

摘　　要：目的 探究细菌性肺炎患儿外周血细胞计数、形态学检查及其与感染程度的相关性。方法 选取2021年1月~2021年12月邯郸市第一医院100例细菌性肺炎患儿作为观察组,另选取同期病毒性肺炎患儿100例作为对照组。比较两组外周血细胞及常规感染指标,评价外周血细胞及常规感染指标对细菌性肺炎的鉴别诊断价值;比较不同感染程度患儿外周血细胞及常规感染指标,分析外周血细胞及常规感染指标与感染程度的相关性,并分析不同感染程度患儿外周血细胞与常规感染指标的相关性,评价外周血细胞及常规感染指标对细菌性肺炎感染加重风险的影响。结果 观察组C-反应蛋白(CRP)[(15.89±3.12)mg/L vs(6.74±1.63)mg/L]、降钙素原(PCT)[(6.28±1.32)μg/L vs(0.92±0.21)μg/L]、白细胞计数(WBC)[(13.27±3.65)×10^(9)/L vs(6.58±1.23)×10^(9)/L]、核左移[(32.54±8.07)个vs(10.23±2.75)个]及中性粒细胞中毒颗粒分级[3(2,4)vs 0(0,1)]均高于对照组(P<0.05);CRP、PCT、WBC、核左移、中性粒细胞中毒颗粒分级鉴别诊断细菌性肺炎的AUC值均在0.7以上,联合诊断AUC值为0.928,明显高于各指标单独诊断AUC值(P均<0.05);细菌性肺炎患儿CRP、PCT、WBC、核左移、中性粒细胞中毒颗粒分级与感染程度呈正相关(P<0.05);轻度、中度及重度细菌性肺炎患儿CRP、PCT均与WBC、核左移、中性粒细胞中毒颗粒分级呈正相关(P<0.05);当CRP、PCT、WBC、核左移、中性粒细胞中毒颗粒分级比例处于高水平时,细菌性肺炎患儿感染加重的相对危险度增加,分别是2.438(95%CI:1.586~3.747)、2.056(95%CI:1.372~3.080)、1.895(95%CI:1.278~2.810)、2.667(95%CI:1.708~4.163)、3.231(95%CI:1.993~5.237)。结论 外周血细胞形态检查作为感染性疾病诊断指标,联合CRP、PCT、WBC对肺炎感染类型,特别是细菌性肺炎早期鉴别诊断效能较高,且与感染程度密切相关。外周血细胞形态检查联合常规感染监测指标诊断可�Objective To explore the correlation of peripheral blood cell count and morphological examination with infection degree in children with bacterial pneumonia.Methods 100 children with bacterial pneumonia in the First Hospital of Handan City from January 2021 to December 2021 were selected as the observation group,and another 100 children with viral pneumonia were selected as the control group.The differential diagnosis value of peripheral blood cells and conventional infection indexes in bacterial pneumonia was analyzed.Peripheral blood cells and conventional infection indicators in children with different infection degrees were compared to analyze the correlation between peripheral blood cells and conventional infection indicators and the degree of infection,and the correlation between peripheral blood cells and conventional infection indicators in children with different infection degrees was evaluated to evaluate the impact of peripheral blood cells and conventional infection indicators on the risk of worsening bacterial pneumonia infection.Results The levels of C-reactive protein( CRP) [( 15.89 ± 3.12) mg/L 2vs( 6.74 ± 1.63) mg/L],procalcitonin( PCT) [( 6.28 ± 1.32) μg/L vs( 0.92 ± 0.21) μg/L],white blood cell count( WBC) [( 13.27 ± 3.65) × 10^(9)/L vs( 6.58 ± 1.23) × 10^(9)/L],left nuclear shift [( 32.54 ± 8.07) vs( 10.23± 2.75) ],and neutrophil toxic particle grading [3( 2,4) vs 0( 0,1) ] in the observation group were all higher than those in the control group( P < 0.05).The AUC score for differential diagnosis of bacterial pneumonia by CRP,PCT,WBC,nuclear left shift,and neutrophil toxic particle grading was all above 0.7,and the AUC value for combined diagnosis was 0.928,which was significantly higher than the AUC value for individual diagnosis of each indicator( P < 0.05).There was a positive correlation between CRP,PCT,WBC,left nuclear shift,neutrophil toxic particle grading and infection severity in children with bacterial pneumonia( P < 0.05).CRP and PCT in children with mild,moderate,and se

关 键 词：细菌性肺炎 外周血细胞计数 细胞形态学 感染程度 相关性 

分 类 号：R725.6[医药卫生—儿科]