中性粒细胞新参数NEU-X、NEU-Y、NEU-Z在败血症中的临床价值  

Clinical value of new neutrophil parameter NEU-X,NEU-Y and NEU-Z in diagnosis of sepsis

作　　者：王天凯[1] 刘琳[1] 金佩佩[2] 王芳[2] 丁宁 WANG Tiankai;LIU Lin;JIN Peipei;WANG Fang;DING Ning(Department of Clinical Laboratory,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201801,China;Hainan Hospital(Hainan Boao Research Hospital),Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Sanya 571437,Hainan,China)

机构地区：[1]上海交通大学医学院附属瑞金医院检验科,上海201801 [2]上海交通大学医学院附属瑞金医院海南医院(海南博鳌研究型医院),海南三亚571437

出　　处：《检验医学》2024年第7期682-686,共5页Laboratory Medicine

基　　金：海南省卫生健康行业科研项目(22A200342、22A200174)。

摘　　要：目的评估血液分析仪中性粒细胞新参数NEU-X、NEU-Y、NEU-Z在败血症辅助诊断中的作用。方法选取2021年1—12月上海交通大学医学院附属瑞金医院北部院区55例败血症住院患者(败血症组)、73例非败血症住院患者(非败血症组)和175名体检健康者(健康对照组)。检测所有研究对象C反应蛋白(CRP)、白细胞(WBC)计数、中性粒细胞绝对数(NEUT#)和NEU-X、NEU-Y和NEU-Z。采用Pearson相关分析评价败血症组NEUT#和NEU-X、NEU-Y与降钙素原(PCT)的相关性。根据感染病原菌种类将败血症患者分为革兰阴性菌感染组、革兰阳性菌感染组和真菌感染组,比较3组NEU-X、NEU-Y和NEU-Z的差异。采用受试者工作特征(ROC)曲线评价NEU-X、NEU-Y、NEU-Z诊断败血症的效能。结果败血症组NEU-X和NEU-Y显著高于健康对照组和非败血症组(P<0.001);CRP、WBC计数和NEUT#显著高于健康对照组(P<0.001),但与非败血症组差异无统计学意义(P>0.05)。NEU-X、NEU-Y、NEU-Z与PCT呈正相关(r值分别为0.3925、0.5323、0.4160,P<0.01)。真菌感染组NEU-Y低于革兰阴性菌感染组(P<0.05)。NEU-X和NEU-Y诊断败血症的ROC曲线下面积分别为0.6818[95%可信区间(CI)为0.5889~0.7784]和0.8103(95%CI为0.7310~0.8897)。结论NEU-X、NEU-Y可用于辅助诊断败血症。Objective To evaluate the role of new neutrophil parameters(NEU-X,NEU-Y and NEU-Z)in the auxiliary diagnosis of sepsis.Methods Totally,55 sepsis inpatients,73 non-sepsis inpatients and 175 healthy subjects from the North Branch of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to December 2021 were enrolled.C-reactive protein(CRP),white blood cell(WBC)count,the absolute value of neutrophils(NEUT#)NEUT count and NEU-X,NEU-Y and NEU-Z were compared among the 3 groups.The correlation between NEU-X,NEU-Y,NEU-Z and procalcitonin(PCT)in sepsis group was analyzed by Pearson analysis.Sepsis group was sub-classified into Gram-negat=ive bacterium infection group,Gram-positive bacterium infection group and fungal infection group,and the differences of NEU-X,NEU-Y and NEU-Z among the 3 groups were compared.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of NEU-X,NEU-Y and NEU-Z in diagnosing sepsis.Results NEU-X and NEU-Y in sepsis group were higher than those in healthy control group and non-sepsis group(P<0.001),CRP,WBC count and NEUT#were higher than those in healthy control group(P<0.001),but there was no statistical significance between them and non-sepsis group(P>0.05).NEU-X,NEU-Y and NEU-Z were positively correlated with PCT(r values were 0.3925,0.5323,0.4160,P<0.01).NEU-Y in fungal infection group was lower than that in Gram-negative bacteria infection group(P<0.05).The area under curve of NEU-Y for the diagnosis of sepsis was 0.6818[95%confidence interval(CI)0.5889-0.7784].The area under curve of NEU-Y was 0.8103(95%CI 0.7310-0.8897).Conclusions NEU-X and NEU-Y can be used in the auxiliary diagnosis of sepsis.

关 键 词：中性粒细胞 新参数 败血症 C反应蛋白 诊断 

分 类 号：R446.11[医药卫生—诊断学]