未成熟网织红细胞在小儿感染性疾病早期诊断中的价值

Clinical Utility of Immature Reticulocyte Fraction in the Early Stage Diagnosis of Children with Infections

目的 探讨未成熟网织红细胞指数(IRF)检测在小儿感染性疾病中的诊断意义.方法 应用流式细胞术对已证实的73例急性病毒性感染患儿和41例急性细菌性感染患儿的IRF含量进行测定,同时检测了白细胞(WBC)总数、中性粒细胞百分比(N)及淋巴细胞百分比(L),并比较其临床意义.结果 病毒感染组IRF(1.32±0.75)明显低于细菌感染组(5.15±2.79)及正常对照组(6.71±3.30)(P＜0.01),病毒感染组IRF＜2.5患者阳性率(93.15%)明显高于细菌感染组(9.76%)、支原体感染组(40%)及正常对照组(0)(P均＜0.01).IRF＜2.5 判断为病毒感染:敏感性为93.15%、特异性为91.35%,明显高于WBC计数及分类(P＜0.01).病毒感染组IRF均数的95%置信区间为(1.14～1.49),细菌感染组IRF均数的95%置信区间为(4.27～6.03).结论 IRF是病毒感染早期诊断的新型指标,其诊断价值明显优于白细胞计数和分类;IRF水平高低可作为是否使用抗菌药物的参考依据.

Objective To investigate the diagnostic significance of immature reticulocyte fraction(IRF)in the diagnosis of virus infection.Methods In the test,we measure the IRF of 73 clinical confirmed child patients with acute virus infection and 41 clinical confirmed child-patients with acute bacterial infection using Flow Cytometer(Sysmex XE-2100),analyze the amount of WBC and percentage of neutrophil and lymphocyte of the same time,then evaluate its clinical significance.Results The IRF of virus infection group(1.32±0.75) is significantly lower(P<0.01)than the IRF of bacterial infection group(5.15±2.79) and the control group(6.71±3.30),the positive ratio of virus infection group(IRF<2.5)is significantly higher than those of bacterial infection group(9.76%);Mycoplasma infection group(40%)and the control group(0)(P<0.01).So,IRF<2.5 is regarded as an indicator of virus infection:sensitivity is 93.15%,specificity is 91.35%,significantly higher than WBC count and differentiate(P<0.01).The 95% confidence interval for mean of virus infection group's IRF is 1.14～1.49,while the bacterial infection group is 4.27～6.03.Conclusions The result suggest that IRF is a new marker for the early stage diagnosis of virus infection,its diagnostic value is better than leucocyte count and WBC differentiate and the level of IRF may be used as an indicator for antibacterial therapy.