摘要
目的探讨白细胞分类及中性粒细胞/淋巴细胞比值在脓毒症患者中变化的临床意义。方法选取2014年1月1日-2018年12月30日中山大学附属第一医院收治的感染性疾病患者351例,根据脓毒症诊断标准分为脓毒症组(n=87)和非脓毒症组(n=264)。所有患者均进行白细胞计数(WBC)、中性粒细胞计数(NEUT)、中性粒细胞百分比(NEUT%)、淋巴细胞计数(LYM)、淋巴细胞百分比(LYM%)、单核细胞计数(MO)、单核细胞百分比(MO%)、血清降钙素原(PCT)、血清C-反应蛋白(CRP)检测,并根据中性粒细胞计数和淋巴细胞计数计算中性粒细胞/淋巴细胞比值(NLR)。采用SPSS 22.0统计软件进行组间比较,分析各指标对脓毒症的诊断效能,筛选脓毒症的危险因素。结果脓毒症组的WBC、NEUT、NUET%、NLR、PCT、CRP均较非脓毒症组高,LYM、LYM%、MO%均较非脓毒症低,差异均有统计学意义(P均<0.05)。MO计数在两组间差异无统计学意义(P=0.873)。ROC曲线结果提示,PCT、NEUT%、LYM%、NLR、NEUT对脓毒症诊断有一定准确性(0.7<AUC<0.9)。二元Logistic回归分析显示,NEUT(OR=1.11,95%CI:1.05~1.18)、PCT(OR=1.05,95%CI:1.01~1.09)越高,患者患脓毒症的可能性更大。结论中性粒细胞、淋巴细胞、单核细胞、NLR在感染性疾病中会有不同的变化。NEUT、NEUT%、LYM%、NLR在脓毒症诊断中均具有很好的诊断价值,PCT和中性粒细胞计数在脓毒症的诊断中作用更优。
Objective To investigate the clinical significance of leukocyte classification and neutrophil/lymphocyte ratio in patients with sepsis.Methods Retrospective analysis of 351 patients with infectious diseases admitted to the First Affiliated Hospital of Zhongshan University from January 1,2014 to December 30 th-2018 was conducted.According to the diagnostic criteria of sepsis,the patients were divided into sepsis group(n=87)and non sepsis group(n=264).White blood cell count(WBC),neutrophil count(NEUT),neutrophil percentage(NEUT%),lymphocyte count(LYM),lymphocyte percentage(LYM%),monocyte count(MO),monocyte percentage(MO%),procalcitonin(PCT)and Creactive protein(CRP)were performed in all patients.Neutrophil to lymphocyte ratio(NLR)was calculated according to blood routine test results.SPSS 22.0 statistical software was used to make inter-group comparison,analyze the diagnostic efficacy of each indicator for sepsis,and screen the risk factors of sepsis.Results Compared to the non-sepsis group,the increment levels of WBC,NEUT,NEUT%,NLR,PCT,CRP and the decrease of LYM,LYM%,MO%were statistical difference in sepsis group(All P<0.05).There was no statistical difference in MO between the two groups(P=0.873).The ROC results of leukocyte classification show that PCT,NEUT%,NLR,LYM%,NEUT,had certain accuracy in the diagnosis of sepsis(0.7<AUC<0.9).According to the results of binary logistic regression analysis,the higher of the neutrophil count(OR=1.11,95%CI:1.05-1.18)and PCT(OR=1.05,95%CI:1.01-1.09),the more likely the patient had sepsis.Conclusions Neutrophils,lymphocytes,mononuclear cells and NLR had different changes in infectious diseases.NEUT,NEUT%,LYM%,and NLR had certain diagnostic value in the diagnosis of sepsis.PCT and neutrophil count might play a better role in the diagnosis of sepsis.
作者
李慧琳
刘舒嫣
刘盛
王皓翔
林爱华
马中富
LI Hui⁃lin;LIU Shu⁃yan;LIU Sheng;WANG Hao⁃xiang;LIN Ai⁃hua;MA Zhong⁃fu(Department of General Practice,the First Affiliated Hospital of Sun Yat⁃sen University,Guangzhou,Guangdong 510080;Department of General,the Seventh Affiliated Hospital of Sun Yat⁃sen University,Shenzhen,Guangdong 518107;Department of General,Longhua District People's Hospital,Shenzhen,Guangdong 518000;School of Public Health,Sun Yat⁃sen University,Guangzhou,Guangdong 510080,China)
出处
《热带医学杂志》
CAS
2022年第1期32-36,146,共6页
Journal of Tropical Medicine
基金
广州市科技计划项目(201300000160)
第三军医大学2020年度“创伤、烧伤与复合伤国家重点实验室开放基金”(KLKF202021)
作者简介
李慧琳,女,硕士研究生,研究方向为炎症与免疫反应;通信作者:马中富,E⁃mail:mazhf@mail.sysu.edu.cn
