CAJ | 학술논문

目的：评价未成熟粒细胞(IG)计数在全身炎症反应综合征(SIRS)中的诊断价值及预后观察,为 SIRS 的诊断和疾病的预后提供新的检验指标。方法选取易引起 SIRS 的患者207例,连续监测其 IG 动态变化与疾病进展的情况。采集 EDTA-2K抗凝血标本,用 Sysmex XE-2100血液分析仪进行全血细胞计数和 IG 计数,同时测定 C-反应蛋白(CRP)和前降钙素原(PCT)。利用受试者工作特征曲线(ROC 曲线)分析并计算曲线下面积(AUC),确定各参数用于诊断的灵敏度和特异度。并连续观察同一患者三项指标的动态变化与临床表现的情况。结果将 IG 绝对计数 IG#>0.165定为诊断 SIRS 的 cut-off 值,AUC 为0.78,灵敏度为62.2%,特异度为73%；IG 相对计数 IG%>2.55%时,AUC 为0.771,灵敏度为54.1%,特异度为94.6%；CRP>64.15 mg/L 定为阈值,AUC 为0.716,灵敏度为67.6%,特异度为75.7%；PCT>0.33 mg/L 定为阈值,AUC 为0.772,灵敏度为75.7%,特异度为70.3%。结论IG 计数在全身炎症反应综合征中的诊断及预后观察中有较好的应用价值。
목적：평개미성숙립세포(IG)계수재전신염증반응종합정(SIRS)중적진단개치급예후관찰,위 SIRS 적진단화질병적예후제공신적검험지표。방법선취역인기 SIRS 적환자207례,련속감측기 IG 동태변화여질병진전적정황。채집 EDTA-2K항응혈표본,용 Sysmex XE-2100혈액분석의진행전혈세포계수화 IG 계수,동시측정 C-반응단백(CRP)화전강개소원(PCT)。이용수시자공작특정곡선(ROC 곡선)분석병계산곡선하면적(AUC),학정각삼수용우진단적령민도화특이도。병련속관찰동일환자삼항지표적동태변화여림상표현적정황。결과장 IG 절대계수 IG#>0.165정위진단 SIRS 적 cut-off 치,AUC 위0.78,령민도위62.2%,특이도위73%；IG 상대계수 IG%>2.55%시,AUC 위0.771,령민도위54.1%,특이도위94.6%；CRP>64.15 mg/L 정위역치,AUC 위0.716,령민도위67.6%,특이도위75.7%；PCT>0.33 mg/L 정위역치,AUC 위0.772,령민도위75.7%,특이도위70.3%。결론IG 계수재전신염증반응종합정중적진단급예후관찰중유교호적응용개치。
Objective To evaluate the value of immature granulocytes count in diagnosing and monitoring the systemic inflam-matory response for patients with systemic inflammatory response syndrome,and to provide a new indicator of systemic inflammato-ry response.Methods 207 patients suspected of systemic inflammatory response syndrome were enrolled.The dynamic changes of immature granulocytes counts and the disease situation were recorded for all subjects.The blood samples were collected in vacuum tubes with EDTA-K2 anticoagulant.Blood cell count and immature granulocytes count were performed in Sysmex XE-2100 hema-tology analyzer.The determination of C-reactive protein and procalcitonin were also completed.The performance of immature granu-locytes in diagnosing systemic inflammatory response syndrome was evaluated by receiver operating characteristic curve analysis. Results The area under the curve of immature granulocyte count (IG #)was 0.78 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 62.2 % and a specificity of 73 % at IG #> 0.1 65.The area under the curve of immature granulo-cyte percent (IG%)was 0.771 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 54.1 % and a specifici-ty of 94.6 % at IG%>2.55 %.The area under the curve of C-reactive protein was 0.71 6 in diagnosing systemic inflammatory re-sponse syndrome,with a sensitivity of 67.6% and a specificity of 75.7 % at C-reactive protein> 64.15 mg/L.The area under the curve of procalcitonin was 0.772 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 75.7 % and a speci-ficity of 70.3 % at procalcitonin> 0.33 mg/L.Conclusion Immature granulocyte count is beneficial for the diagnosis and the as-sessment of prognosis of systemic inflammatory response syndrome.