877例发热门诊患者白细胞与C反应蛋白的临床分析

Clinical analysis on white blood cell counts and C-reactive protein in 877 febrile patients

目的总结发热门诊患者白细胞(WBC)和C-反应蛋白(C-reactive protein,CRP)的情况。方法回顾性分析2013年7-11月北京天坛医院发热门诊患者的初步诊断、血常规和CRP数据。结果发热患者877例,男女年龄组无差异(P=0.956)。初步诊断排名前3位的疾病分别为上呼吸道感染、肺炎、气管炎或支气管炎。在上呼吸道感染和肺炎患者中,男性WBC计数均明显高于女性[(10.75±4.12)×109/L vs.(9.77±3.90)×109/L,P=0.005;(10.43±4.01)×109/L vs.(8.97±3.31)×109/L,P=0.02)]。男性肺炎患者CRP高于女性(44.2 mg/L vs.32.0 mg/L,P=0.018)。结论 WBC和CRP联合检测能够较好评估发热患者,减少误诊和漏诊,还应重视淋巴细胞计数和中性粒细胞-淋巴细胞计数比值的评价。

Objective To summarize the charicteristics of white blood cells （WBC） and C-reactive protein （CRP） in febrile patients. Methods The data of the patients with the chief complaint of fever in the department of fever were retro-spectively analyzed from July to November, 2013, such as the primary diagnosis, WBC and CRP. Results A total of 877 patients with fever were studied. There was no age difference between male and female group （P = 0.956）. The first three primary diagnoses were upper respiratory tract infection, pneumonia and tracheitis/bronchitis. Among upper respiratory tract infection and pneumonia, WBC count in the male group was higher than that in the female group [（10.75±4.12）×109/L vs. （9.77±3.90）×109/L, P = 0.005; （10.43±4.01）×109/L vs. （8.97±3.31）×109/L, P = 0.02）]. For the pneumonia, CRP in the male group was higher than that in the female group （44.2mg/L vs. 32.0mg/L, P=0.018）. Conclusion The combina-tion of WBC and CRP may be a valuable markers for the diagnosis in patients with fever at the fever department. The lymphocyte count should be emphasized and neutrophil-lymphocyte count ratio should be measured for early diagnosis and treatment of patients with fever.