中性粒细胞群落参数监测术后并发感染的应用

Application of neutrophil VCS parameters in postoperative infection

目的分析中性粒细胞(VCS)参数在机体应激状态时的变化,并探讨其诊断应激状态并发细菌感染的可能。方法使用Coulter LH 750血液分析仪检测21例经细菌培养确诊术后并发感染者和23例术后无感染症状者的外周血血常规,记录WBC、NE%和中性粒细胞的各项VCS参数;同时监测患者血清超敏C反应蛋白(hs-CRP)水平,然后进行组间指标比较分析,并对VCS参数与hs-CRP进行相关性分析。结果白细胞计数(WBC)和中性粒细胞百分率(NE%)在无感染症状组与感染组间差异无统计学意义(P>0.05)。而中性粒细胞VCS参数在术后第2天差异有统计学意义(P<0.05);中性粒细胞转换参数在ROC曲线下面积为0.831,大于其他指标;在术后并发细菌感染人群的临界值大于或等于27.12时,其敏感性和特异性为68.29%和81.93%。且其与hs-CRP水平呈正相关关系(r=0.774,P=0.000)。结论继发的细菌感染导致应激状态下中性粒细胞VCS参数的显著性变化,转换的中性粒细胞新参数在应激状态并发细菌感染者中出现了显著性的增大。

Objective To analyze the changes of neutrophil（NE） VCS parameters in stringent state patients,and investigate the clinical application of VCS parameters for the diagnosis of postoperative bacterial infection.Methods Peripheral blood specimens from 21 patients with postoperative infection（infection group） and 23 patients without postoperative infectious symptom（non-infection group） were detected by using Coulter LH 750 for white blood cells counts（WBC）,percentage of NE（NE%） and VCS parameters of NE,and serum level of high sensitivity C reaction protein（hs-CRP） were also detected.Results of the two research groups were compared and the correlation between VCS parameters and hs-CRP were analyzed.Results There were no statistical difference of WBC and NE% between the two groups（P0.05）.But in the next day after operation,a significant increase of VCS parameters was observed in infection group,compared with non-infection group（P0.05）.The area under receiver operating characteristic curve（AUC） of NE-Index was 0.831,higher than other parameters.The diagnostic sensitivity and specificity of NE-Index for bacterial infection were 68.29% and 81.93% in postoperative patients,when taking cut-off value of more than or equal with 27.12,and NE-Index was significantly correlated with the level of hs-CRP（r=0.774,P=0.000）.Conclusion Secondum bacterial infection could cause significant changes of VCS parameters of NE-Index during stringent state,and NE-Index might be significant increased patients during stringent state complicated by bacterial infection.