未成熟网织红细胞指数在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 Infectious Diseases

目的探讨未成熟网织红细胞指数(IRF)测定在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98例急性病毒性感染患者和84例急性细菌性感染患者的IRF含量进行测定,同时对RET,IRF,WBC等指标进行ROC分析。结果病毒感染组IRF(1.36±0.81)明显低于细菌感染组(6.01±4.13)及正常对照组(5.53±2.87)(P<0.01);用ROC曲线分析,IRF的AUC=0.908,RET的AUC=0.816,WBC的AUC=0.648,L的AUC=0.671,M的AUC=0.701,N的AUC=0.312.IRF最佳临界值为2.5,其敏感性为93.88%,特异性88.29%,阳性预测值79.31%,阴性预测值96.79%,正确诊断指数(r)82.17%.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 98 clinical confimed patients with acute virus infection and 84 clinical confirmed 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（1.36±0.81） is significantly lower （P〈0.01） than the IRF of bacterial infection group（6.0±4.13） and the control group（5.53±2.87）. ROC analysis showed that AUC so IRF,RET,WBC,L,M,N were 0.908,0.816,0.648,0.671,0.701,0.312.So,IRF〈2.5 is regarded as an indicator of virus infection：sensitivity is 93.88%, specificity is 88.29%, significantly higher than WBC count and differentiate （P〈0.01）. The 95% confidence interval for mean of virus infection group＇s IRF is 1.19-1.52, while the bacterial infection group is 5.11-6.91. Conclusion 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.