中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2008年
12期
1330-1334
,共5页
郭希超%杨大干%俞研迎%陈瑜
郭希超%楊大榦%俞研迎%陳瑜
곽희초%양대간%유연영%진유
细菌感染%白细胞计数
細菌感染%白細胞計數
세균감염%백세포계수
Bacterial infections%Leukocyte count
目的 研究白细胞VCS参数在血液细菌感染中的临床应用.方法 采用Coulter LH 750血细胞分析仪检测120例血液细菌感染患者、69例非感染性发热患者、67名健康对照者的中性粒细胞和淋巴细胞的VCS参数,包括中性粒细胞平均体积(MNV)、中性粒细胞体积分布宽度(NDW)、中性粒细胞平均传导率(MNC)、中性粒细胞平均散射值(MNS);淋巴细胞平均体积(MLV)、淋巴细胞体积分布宽度(LDW)、淋巴细胞平均传导率(MLC)、淋巴细胞平均散射值(MLS).将血液细菌感染组根据白细胞总数分为WBC≤10×109/L组和＞10×109/L组;根据中性粒细胞比例分为≥85%组和＜85%组;根据细菌染色分为革兰阳性细菌感染组和革兰阴性细菌感染组.结果 血液细菌感染组的MNV、NDW、MNS、MLV、LDW、MLC、MLS分别为156 ±15、23.31±3.72、137±7、87±12、17.50±3.38、110±5、69±12;非感染性发热组分别为151±8、21.33 ±2.62、132±10、91±4、15.78±1.96、117±4、62±6;健康对照组分别为145±5、18.43±0.93、143±4、84±2、13.30 ±0.76、108±1、62±2;上述各指标在3组间差异均有统计学意义(F值分别为19.295、26.272、32.767、6.226、31.016、23.739、12.662,P＜0.05或＜0.01).WBC≤10×109/L组MNV和NDW分别为152±16、22.19±3.45,WBC＞10×109/L组分别为159±12、25.29±3.43,与健康对照组比较,3组间差异有统计学意义(F值分别为21.575、40.856,P＜0.01).中性粒细胞百分率≥85%组的MNV、NDW分别为159±12、24.88 ±3.74,中性粒细胞百分率＜85%组分别为151±16、21.68±2.29,与健康对照组比较,3组间差异有统计学意义(F值分别为23.76、43.22,P＜0.01).革兰阴性细菌感染组的MNV和NDW分别为157±15、24.25±3.39,革兰阳性细菌感染组分别为153 ±14、21.51±3.78,与健康对照组3组间比较,差异有统计学意义(F值分别为18.74、37.47,P＜0.01).在血液细菌感染诊断中,当NDW的临界值(cut-off值)取20.50时,敏感度为76.7%,特异度为98.3%.结论 VCS参数能反映血液细菌感染时白细胞的形态学变化,其中NDW参数能更加灵敏、特异地反映血液细菌感染.
目的 研究白細胞VCS參數在血液細菌感染中的臨床應用.方法 採用Coulter LH 750血細胞分析儀檢測120例血液細菌感染患者、69例非感染性髮熱患者、67名健康對照者的中性粒細胞和淋巴細胞的VCS參數,包括中性粒細胞平均體積(MNV)、中性粒細胞體積分佈寬度(NDW)、中性粒細胞平均傳導率(MNC)、中性粒細胞平均散射值(MNS);淋巴細胞平均體積(MLV)、淋巴細胞體積分佈寬度(LDW)、淋巴細胞平均傳導率(MLC)、淋巴細胞平均散射值(MLS).將血液細菌感染組根據白細胞總數分為WBC≤10×109/L組和＞10×109/L組;根據中性粒細胞比例分為≥85%組和＜85%組;根據細菌染色分為革蘭暘性細菌感染組和革蘭陰性細菌感染組.結果 血液細菌感染組的MNV、NDW、MNS、MLV、LDW、MLC、MLS分彆為156 ±15、23.31±3.72、137±7、87±12、17.50±3.38、110±5、69±12;非感染性髮熱組分彆為151±8、21.33 ±2.62、132±10、91±4、15.78±1.96、117±4、62±6;健康對照組分彆為145±5、18.43±0.93、143±4、84±2、13.30 ±0.76、108±1、62±2;上述各指標在3組間差異均有統計學意義(F值分彆為19.295、26.272、32.767、6.226、31.016、23.739、12.662,P＜0.05或＜0.01).WBC≤10×109/L組MNV和NDW分彆為152±16、22.19±3.45,WBC＞10×109/L組分彆為159±12、25.29±3.43,與健康對照組比較,3組間差異有統計學意義(F值分彆為21.575、40.856,P＜0.01).中性粒細胞百分率≥85%組的MNV、NDW分彆為159±12、24.88 ±3.74,中性粒細胞百分率＜85%組分彆為151±16、21.68±2.29,與健康對照組比較,3組間差異有統計學意義(F值分彆為23.76、43.22,P＜0.01).革蘭陰性細菌感染組的MNV和NDW分彆為157±15、24.25±3.39,革蘭暘性細菌感染組分彆為153 ±14、21.51±3.78,與健康對照組3組間比較,差異有統計學意義(F值分彆為18.74、37.47,P＜0.01).在血液細菌感染診斷中,噹NDW的臨界值(cut-off值)取20.50時,敏感度為76.7%,特異度為98.3%.結論 VCS參數能反映血液細菌感染時白細胞的形態學變化,其中NDW參數能更加靈敏、特異地反映血液細菌感染.
목적 연구백세포VCS삼수재혈액세균감염중적림상응용.방법 채용Coulter LH 750혈세포분석의검측120례혈액세균감염환자、69례비감염성발열환자、67명건강대조자적중성립세포화림파세포적VCS삼수,포괄중성립세포평균체적(MNV)、중성립세포체적분포관도(NDW)、중성립세포평균전도솔(MNC)、중성립세포평균산사치(MNS);림파세포평균체적(MLV)、림파세포체적분포관도(LDW)、림파세포평균전도솔(MLC)、림파세포평균산사치(MLS).장혈액세균감염조근거백세포총수분위WBC≤10×109/L조화＞10×109/L조;근거중성립세포비례분위≥85%조화＜85%조;근거세균염색분위혁란양성세균감염조화혁란음성세균감염조.결과 혈액세균감염조적MNV、NDW、MNS、MLV、LDW、MLC、MLS분별위156 ±15、23.31±3.72、137±7、87±12、17.50±3.38、110±5、69±12;비감염성발열조분별위151±8、21.33 ±2.62、132±10、91±4、15.78±1.96、117±4、62±6;건강대조조분별위145±5、18.43±0.93、143±4、84±2、13.30 ±0.76、108±1、62±2;상술각지표재3조간차이균유통계학의의(F치분별위19.295、26.272、32.767、6.226、31.016、23.739、12.662,P＜0.05혹＜0.01).WBC≤10×109/L조MNV화NDW분별위152±16、22.19±3.45,WBC＞10×109/L조분별위159±12、25.29±3.43,여건강대조조비교,3조간차이유통계학의의(F치분별위21.575、40.856,P＜0.01).중성립세포백분솔≥85%조적MNV、NDW분별위159±12、24.88 ±3.74,중성립세포백분솔＜85%조분별위151±16、21.68±2.29,여건강대조조비교,3조간차이유통계학의의(F치분별위23.76、43.22,P＜0.01).혁란음성세균감염조적MNV화NDW분별위157±15、24.25±3.39,혁란양성세균감염조분별위153 ±14、21.51±3.78,여건강대조조3조간비교,차이유통계학의의(F치분별위18.74、37.47,P＜0.01).재혈액세균감염진단중,당NDW적림계치(cut-off치)취20.50시,민감도위76.7%,특이도위98.3%.결론 VCS삼수능반영혈액세균감염시백세포적형태학변화,기중NDW삼수능경가령민、특이지반영혈액세균감염.
Objective To investigate the clinical application of VCS parameters of leukocyte in the detection of blood bacterial infection, Methods The subjects consisted of 120 patients with blood bacterial infection,69 non-infectious fever patients and 67 health controls.The VCS parameters of neutrophil and lymphocyte were examined with Coulter LH 750 hematology analyzer.The parameters examined including mean channel of neutrophil volume(MNV),neutrophil volume distribution width (NDW) ,mean channel of neutrophil conductivity (MNC),mean channel of neutrophil scatter (MNS),mean channel of lymphocyte volme(MLV),lymphocyte volume distfibufion width (LDW),mean channel of lymphocyte conductivity (MLC) and mean channel of lymphocyte scatter (MLS).Additionally,120 blood bacterial infection patients were grouped according to WBC count(WBC≤10×109/L group and WBC＞10×109/L group),neutrophii rate(≥85%group and＜85%group)and bacterial stain(Gram positive bacteria group and Gram negative bacteria group).VCS parameters among these groups were compared.Results The results of blood infection group were as follows:MNV 156±15,NDW 23.31±3.72,MNS 137±7,MLV 87±12,LDW 17.50±3.38.MLC 110±5 and MLS 69±12.The results of non-infectious fever group were as follows:MNV 151±8,NDW 21.33 ±2.62,MNS 132±10,MLV 91±4.LDW 15.78±1.96.MLC 117±4 and MLS 62±6.The results of control group were as follows:MNV145 ±5.NDW 18.43±0.93.MNS 143 ±4,MLV 84±2,LDW 13.30±0.76.MLC 108±1 and MLS 62±2.There were significant diffierences among these three groups (F value were 19.295,26.272,32.767,6.226,31.016,23.739 and 12.662 respectively,P＜0.05 or P＜0.01).In the infection group.the MNV and NDW were 152 ±16 and 22.19±3.45 respectively for WBC≤10×109/L group.159±12 and 25.29±3.43 respectively for WBC＞10×109/L group.They were both significantly different compared with control group (F valRe were 21.575 and 40.856 respectively,P＜0.01).Also in the infection group.the MNV and NDW were 159±12 and 24.88 ±3.74 respectively for neutrophil rate≥85%group.151±16 and 21.68±2.29 respectively for neutrophil rate＜85%group.They were both significantly different compared with control group(F value were 23.76 and 43.22 respectively,P＜0.01).The MNV and NDW were 157±15 and 24.25±3.39 respectively in those cases with gram-negative bacteremia,153±14 and 21.51±3.78 respectively in those cases with gram-positive bacteremia.They were both signifieanfly difierent compared with control group (F value were 18.74 and 37.47 respectively,P＜0.01).With a cut-off value of 20.50 for the NDW,a sensitivity of 76.7%and specificity of 98.3% were achieyed in diagnosing blood hacterial infection.Conclusion The VCS parameters can reflect the morphologic change of leukocyte in blood bacterial infection.Additionally.the NDW can detect blood bacterial infection more sensitively and specifically.
