CAJ | 학술논문

目的：评价几种实验室检查方法在鉴别糖皮质激素使用与感染造成的白细胞（WBC）升高中的作用。方法收集2011年1月至2012年12月于该院住院治疗的74例患者，根据其病种及治疗方案分为非感染激素组（n＝15）、感染非激素组（n＝29）和感染激素组（n＝30），分别在糖皮质激素和/或抗菌素治疗0、3、7 d 时采集静脉血，对其外周血 C 反应蛋白（CRP）、WBC 计数、WBC 分类计数及中性粒细胞碱性磷酸酶（NAP）积分进行检测，以 CRP 作为判定有无感染及感染程度的指标，比较其他实验室检查指标的变化情况。结果感染激素组与感染非激素组比较，CRP 水平的差异无统计学意义（P ＞0．05），呈逐渐降低趋势；非感染激素组应用激素3 d 和7 d 时与应用激素前进行比较，中性粒细胞计数、NAP 积分均显著增高（P ＜0．01），淋巴细胞计数显著降低（P ＜0．05），嗜酸性中性粒细胞差异无统计学意义（P ＞0．05）。结论糖皮质激素与感染造成的外周血 WBC 升高，无法通过 WBC 分类计数、WBC 升高绝对值及 NAP 积分进行鉴别。
목적：평개궤충실험실검사방법재감별당피질격소사용여감염조성적백세포（WBC）승고중적작용。방법수집2011년1월지2012년12월우해원주원치료적74례환자，근거기병충급치료방안분위비감염격소조（n＝15）、감염비격소조（n＝29）화감염격소조（n＝30），분별재당피질격소화/혹항균소치료0、3、7 d 시채집정맥혈，대기외주혈 C 반응단백（CRP）、WBC 계수、WBC 분류계수급중성립세포감성린산매（NAP）적분진행검측，이 CRP 작위판정유무감염급감염정도적지표，비교기타실험실검사지표적변화정황。결과감염격소조여감염비격소조비교，CRP 수평적차이무통계학의의（P ＞0．05），정축점강저추세；비감염격소조응용격소3 d 화7 d 시여응용격소전진행비교，중성립세포계수、NAP 적분균현저증고（P ＜0．01），림파세포계수현저강저（P ＜0．05），기산성중성립세포차이무통계학의의（P ＞0．05）。결론당피질격소여감염조성적외주혈 WBC 승고，무법통과 WBC 분류계수、WBC 승고절대치급 NAP 적분진행감별。
Objective To evaluate the role of several traditional laboratory examinations in identifying the cause of WBC count increase,which might be the adverse reaction of glucocorticoid or infection.Methods 74 patients treated in the hospital from Jan. 2011 to Dec.2012 were recruited in the study.Glucocorticoid without Infection(n =15 ),Infection without Glucocorticoid(n =29) and Infection with Glucocorticoid(n=30)Group were devided according to the type of disease and therapies.After being treated for 0,3,7 d,respectively venous blood samples of patients were collected to determine the concentration of CRP,WBC count,leukocyte classification and NAP score.CRP was used as the Judgment index for the degree of infection,the changes of other indexes were compared.Results Compared with the Infection without Glucocorticoid Group,the CRP concentration of the Infection with Glu-cocorcoid Group was becoming lower(P >0.05).The Non-infection with Glucocorticoid Group applied glucocorticoid for 3 days and 7 days respectively,the count of neutrophilic granulocyte and NAP score increased significantly compared with that before glucocor-ticoid application(P <0.01)while the count of lymphocyte reduced(P <0.05)and no significant change in the count of eosnophils (P >0.05).Conclusion The increase of WBC after glucocorticoid can not be identified whether it is the adverse reaction of glu-cocorticoid or aggravated infection by using classification of leukocyte,the increasing amount of WBC and NAP score.