中性粒细胞新参数NEU-X、NEU-Y、NEU-Z在败血症中的临床价值

doi:10.3969/j.issn.1673-8640.2024.07.011

摘要/Abstract

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0.392 5、0.532 3、0.416 0，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0.681 8[95%可信区间（CI）为0.588 9~0.778 4]和0.810 3（95%CI为0.731 0~0.889 7）。结论 NEU-X、NEU-Y可用于辅助诊断败血症。

关键词: 中性粒细胞, 新参数, 败血症, C反应蛋白, 诊断

Abstract:

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 0.392 5，0.532 3，0.416 0，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 0.681 8 [95% confidence interval （CI） 0.588 9-0.778 4]. The area under curve of NEU-Y was 0.810 3 （95%CI 0.731 0-0.889 7）. Conclusions NEU-X and NEU-Y can be used in the auxiliary diagnosis of sepsis.

Key words: Neutrophil, New parameter, Sepsis, C-reactive protein, Diagnosis

中图分类号:

R446.11

王天凯, 刘琳, 金佩佩, 王芳, 丁宁. 中性粒细胞新参数NEU-X、NEU-Y、NEU-Z在败血症中的临床价值[J]. 检验医学, 2024, 39(7): 682-686.

WANG Tiankai, LIU Lin, JIN Peipei, WANG Fang, DING Ning. Clinical value of new neutrophil parameter NEU-X，NEU-Y and NEU-Z in diagnosis of sepsis[J]. Laboratory Medicine, 2024, 39(7): 682-686.

图/表 5

参考文献 21

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组别	例数	NEU-X	NEU-Y	NEU-Z
败血症组	55	373.40（346.70，394.40）*^#	535.70（509.40，570.80）*^#	1 758.10（1 698.50，1 833.50）
非败血症组	73	350.70（333.40，373.80）^#	487.80（472.15，512.55）^#	1 788.80（1 687.40，1 841.80）
健康对照组	175	320.10（307.70，336.90）	444.60（430.80，462.40）	1 764.00（1 707.70，1 813.10）
F值		86.42	161.4	0.39
P值		<0.001	<0.001	0.68
组别	CRP/mg·L^-1		WBC/（×109·L^-1）	NEUT#/（×109·L^-1）
败血症组	63.00（35.00，95.00）^#		9.00（6.57，14.79）^#	7.16（4.80，12.91）^#
非败血症组	50.00（15.00，96.00）^#		8.81（6.06，12.95）^#	6.08（4.30，10.95）^#
健康对照组	6.00（4.00，7.00）		5.63（4.85，6.68）	3.23（2.66，4.03）
F值	128.7		63.09	85.39
P值	<0.001		<0.001	<0.001

组别	例数	NEU-X	NEU-Y	NEU-Z
败血症组	55	373.40（346.70，394.40）*^#	535.70（509.40，570.80）*^#	1 758.10（1 698.50，1 833.50）
非败血症组	73	350.70（333.40，373.80）^#	487.80（472.15，512.55）^#	1 788.80（1 687.40，1 841.80）
健康对照组	175	320.10（307.70，336.90）	444.60（430.80，462.40）	1 764.00（1 707.70，1 813.10）
F值		86.42	161.4	0.39
P值		<0.001	<0.001	0.68
组别	CRP/mg·L^-1		WBC/（×109·L^-1）	NEUT#/（×109·L^-1）
败血症组	63.00（35.00，95.00）^#		9.00（6.57，14.79）^#	7.16（4.80，12.91）^#
非败血症组	50.00（15.00，96.00）^#		8.81（6.06，12.95）^#	6.08（4.30，10.95）^#
健康对照组	6.00（4.00，7.00）		5.63（4.85，6.68）	3.23（2.66，4.03）
F值	128.7		63.09	85.39
P值	<0.001		<0.001	<0.001

组别	例数/例	NEU-X	NEU-Y	NEU-Z
革兰阴性菌感染组	34	373.80（352.28，395.15）	554.00（520.80，595.25）	1 759.50（1 705.85，1 833.93）
革兰阳性菌感染组	15	378.60（345.80，394.40）	532.40（490.30，557.90）	1 719.50（1 643.60，1 842.20）
真菌感染组	6	342.75（316.50，386.68）	493.60（456.13，530.00）^*	1 768.40（1 678.95，1 810.93）
F值		1.16	3.60	2.21
P值		0.32	0.02	0.12

组别	例数/例	NEU-X	NEU-Y	NEU-Z
革兰阴性菌感染组	34	373.80（352.28，395.15）	554.00（520.80，595.25）	1 759.50（1 705.85，1 833.93）
革兰阳性菌感染组	15	378.60（345.80，394.40）	532.40（490.30，557.90）	1 719.50（1 643.60，1 842.20）
真菌感染组	6	342.75（316.50，386.68）	493.60（456.13，530.00）^*	1 768.40（1 678.95，1 810.93）
F值		1.16	3.60	2.21
P值		0.32	0.02	0.12

项目	曲线下面积（95%CI）	最佳临界值	敏感性/%	特异性/%
NEU-X	0.681 8（0.588 9~0.774 8）	366.00	71.23	60.00
NEU-Y	0.810 3（0.731 0~0.889 7）^*	508.90	72.60	76.36
NEU-Z	0.535 0（0.433 8~0.636 2）	1 757.50	57.53	49.09
CRP	0.578 5（0.480 0~0.676 9）	61.00 g·L^-1	61.64	56.36
WBC计数	0.548 1（0.444 4~0.651 7）	10.08×109·L^-1	64.38	47.27
NEUT#	0.562 8（0.459 5~0.666 0）	7.24×109·L^-1	60.27	49.09