摘要
目的探讨新型冠状病毒肺炎(COVID-19)患者血常规中性粒细胞相关参数的变化情况,为临床及时识别重型或危重型患者提供可靠的实验室依据。方法回顾性分析深圳市第三人民医院2020年1月23日-3月21日收治的部分COVID-19患者血常规中白细胞计数(WBC)、中性粒细胞绝对值(NEUT)以及幼稚粒细胞绝对值(IG),参照诊断标准将COVID-19患者分为无症状感染组(n=32)、轻型组(n=19)、普通型组(n=28)、重型组(n=18)和危重型组(n=9)。非COVID-19发热组为同期发热并最终排除单纯疱疹病毒、风疹病毒、巨细胞病毒、EB病毒阳性的COVID-19感染的患者48例,对照组为同期健康体检人员69人。分析各组指标之间的差异。结果各组患者WBC差异有统计学意义(F=7.16,P<0.01),危重组与非COVID-19发热组比较差异无统计学意义(P>0.05),与其他组比较差异均有统计学意义(P均<0.05)。各组患者NEUT差异也有统计学意义(F=9.91,P<0.01),在NEUT参数比较中,危重组中的NEUT最高,且与各组的两两比较中,除重型组与非COVID-19发热组比较差异无统计学意义外,与其他组比较差异均有统计学意义(P<0.05)。各组患者IG差异也有统计学意义(F=8.07,P<0.01),各组IG的比较中,危重组与各组的两两比较差异均有统计学意义(P<0.05);重型组与轻型组、对照组和非COVID-19发热组比较差异均有统计学意义(P<0.05)。血常规中散点图IG能警示危重型患者感染的严重程度。结论NEUT的持续增高预示COVID-19患者病情可能进展到重型、危重型,其中IG的增高趋势警示危重型患者病情的恶化。
Objective To investigate the changes of neutrophil related parameters in blood routine in patients with coronavirus disease 2019(COVID-19)and provide reliable laboratory basis for timely identification of severe or critical patients.Methods The white blood cell count(WBC),neutrophil absolute value(NEUT)and immature granulocyte absolute value(IG)in the blood routine of part patients with COVID-19 admitted to the Shenzhen Third People's Hospital were analyzed,retrospectively.According to the diagnostic criteria,patients with COVID-19 were divided into asymptomatic infection group(n=32),mild group(n=19),normal group(n=28),severe group(n=18)and critical group(n=9),respectively.In the non-COVID-19 fever group,48 patients had fever in the same period and finally excluded COVID-19 infection positive for herpes simplex virus,rubella virus,giant cell virus and EB virus,and 69 healthy physical examination personnel in the physical examination group.Differences of laboratory indicators among each group were statistically analyzed.Results There were significant differences in WBC among all groups(F=7.16,P<0.01).There was no significant difference between the critical group and the non-COVID-19 fever group(P>0.05),but there were significant differences between the critical group and other groups(P<0.05).There were also differences in NEUT among the three groups(F=9.91,P<0.01).In the comparison of NEUT parameters,the critical group had the highest NEUT,and the pairwise comparison with the other groups showed statistically significant differences except for the severe group and the non-COVID-19 fever group(P<0.05).There were also differences in IG among the groups(F=8.07,P<0.01).There were statistically significant differences in the absolute IG of naive granulocytosis among the groups,and in the pairwise comparison between the critical group and the groups(P<0.05).There were statistically significant differences between severe group and mild group,physical examination control group and non-COVID-19 fever group(P<0.05).Scattergram of immature granulocyte IG#in blood routine might indicate the severity of infection in critically severe patients.Conclusion The continuous increase of neutrophils might indicate the condition of COVID-19 patients progressing to severe and critical severe type,and the increasing trend of IG#might indicate the deterioration of critical severe COVID-19 patients.
作者
张文萍
黄华
张仲明
张秋萍
杨燕梅
曲久鑫
ZHANG Wenping;HUANG Hua;ZHANG Zhongming;ZHANG Qiuping;YANG Yanmei;QU Jiuxin(Department of Clinical Laboratory,the Third People's Hospital of Shenzhen,Southern University of Science and Technology,Shenzhen,Guangdong 518112,China;Department of Radiology,the Third People's Hospital of Shenzhen,Southern University of Science and Technology,National Clinical Research Center for Infectious Diseases,Shenzhen,Guangdong 518112,China;Department of Gynaecology and Obstetrics,Shenzhen Luohu Maternal and Child Health Hospital,Shenzhen,Guangdong 518000,China)
出处
《热带医学杂志》
CAS
2023年第10期1442-1445,1502,共5页
Journal of Tropical Medicine
基金
深圳市龙岗区科技发展资金项目(LGKCXGZX2020002)
广东省基础与应用基础研究基金(2020A1515010586)
作者简介
张文萍,女,硕士,主任技师,主要从事血液学机制和血细胞形态学研究;通信作者:曲久鑫,E-mail:qujiuxin@163.com
