中性粒细胞VCS参数在细菌感染与应激性疾病中的应用

The clinical application of neutrophil VCS parameters in the detection of bacterial infection and stringency diseases

目的探讨中性粒细胞VCS参数在急性细菌感染和心脑血管意外、大手术术后及急性消化道出血等应激性疾病中的应用价值。方法利用Coulter LH-750血细胞分析仪检测128例急性细菌感染患者、56例急发性心脑疾病患者、51例大手术术后患者、42例急性消化道出血患者及50名健康对照者中的中性粒细胞VCS参数,包括中性粒细胞平均体积(MNV)、中性粒细胞平均高频传导率(MNC)、中性粒细胞平均激光散射值(MNS)及中性粒细胞体积分布宽度(NDW)。结果急性细菌感染组的MNV、MNC、MNS、NDW分别为(154.90±7.61)fL、146.02±2.56、134.13±6.18、24.88±3.57;急发性心脑疾病组分别为(144.50±6.52)fL、146.64±2.60、139.00±3.50、20.40±2.34、;急性消化道出血组分别为(147.42±5.00)fL、147.00±3.10、138.00±3.91、21.51±2.50;大手术术后组分别为(150.84±5.96)fL、146.20±3.13、136.80±4.87、22.75±1.99;健康对照组分别为(140.22±4.27)fL、147.21±2.05、142.42±6.18、18.56±1.15,急性细菌感染、急发性心脑疾病、急性消化道出血、大手术术后组与对照组的MNV、MNS、NDW差异有统计学意义(P<0.01),以急性细菌感染组的上述各参数变化最为显著。应激性疾病组(包括急发性心脑疾病患者、大手术术后患者和急性消化道出血患者)的MNV、MNS、NDW分别为(147.50±6.29)fL、137.50±4.70、21.66±2.54,与急性细菌感染组比较,差异有统计学意义(P<0.01)。结论中性粒细胞的VCS参数能反映急性细菌感染性疾病与应激性疾病时血液中性粒细胞的形态学变化,以细菌感染疾病变化最为明显。

Abstract： Objective To investigate the clinical application significance of neutrophil VCS parameters in the detection of acute bacterial infection and the stringency diseases with cardiovascular or cerebrovascular accident, major surgery operation and acute gastrointestinal hemorrhage. Methods A total of 128 patients with acute bacterial infection, 56 patients with acute cardiovascular or cerebrovascular disease ,51 patients after major surgery operation, 42 patients with acute gastrointestinal hemorrhage and 50 healthy subjects were enrolled in the study. The neutrophil VCS parameters were determined by Coulter LH-750 hematology analyzer. The parameters included mean neutrophil volume （MNV）, mean neutrophil conductivity （MNC）, mean neutrophil scatter （MNS） and neutrophil volume distribution width （NDW）. Results The results of acute bacterial infection group were as follows： MNV （ 154.90 ± 7.61 ） fL, MNC 146.02 ± 2. 56, MNS 134. 13 ± 6. 18 and NDW 24. 88 ± 3. 57. The results of acute cardiovascular or cerebrovascular disease group were as follows： MNV （144.50±6.52） fL, MNC 146.64 ±2.60, MNS 139.00 ± 3.50 and NDW 20.40 ± 2.34. The results of acute gastrointestinal hemorrhage group were as follows： MNV （ 147.42 ± 5.00） fL, MNC 147.00 ± 3.10, MNS 138.00 ± 3.91 and NDW 21.51 ± 2.50. The results of major surgery operation group were as follows ： MNV （ 150.84 ± 5.96） fL, MNC 146.20 ± 3.13, MNS 136.80 ± 4.87 and NDW 22.75 ± 1.99. The results of healthy control group were as follows ： MNV （ 140.22 ± 4.27 ） fL, MNC 147.21 ± 2.05, MNS 142.42 ±6.18 and NDW 18.56 ± 1.15. There were statistical signifieances of MNV, MNS and NDW between acute bacterial infection, acute cardiovascular or cerebrovascular disease, acute gastrointestinal hemorrhage and major surgery operation groups with healthy control group （ P 〈 0.01 ）. The changes of MNV, MNS and NDW in acute bacterial infection group were the most obvious among those 4 groups. The results of stringency disease group, including acute cardiovascular or cerebrovascular disease group, major surgery operation group and acute gastrointestinal hemorrhagegroup, were as follows ： MNV （ 147.50 ± 6.29） fL, MNS 137.50 ± 4.70 and NDW 21.66 ± 2.54. The differences of these parameters between stringency disease group and acute bacterial infection group had statistical significance （P 〈 0.01 ）. Conclusions The neutrophil VCS parameters can reflect the morphologic changes of neutrophil in acute bacterial infection and common stringency diseases, and the change in aeule bacterial infection is more obvious than that in common stringency diseases.