未成熟粒细胞结合降钙素原及C反应蛋白检测在肺部感染早期诊断中的价值

目的 探讨血液中未成熟粒细胞（IG）联合血清中降钙素原（PCT）及C反应蛋白（CRP）水平在肺部感染性疾病中的变化及其早期临床诊断价值.方法 用sysmex XN-1000血液学分析仪测定200例肺部感染患者及30例健康对照者的白细胞总数（WBC）、中性粒细胞百分比（NE%）、IG百分比（IG%）及IG绝对计数（IG#）,并用免疫荧光分析仪测定其血清的PCT及CRP水平;将肺部感染患者通过临床特征及细菌培养结果 分组,分为细菌性感染组及非细菌性感染组,然后比较各指标的变化及分组统计分析.结果与健康对照组比较,细菌性感染组及非细菌性感染组的WBC、NE%、IG%、IG#、PCT及CRP水平均明显升高（P均〈0.05）;并且细菌感染组的上述指标与非细菌性感染组比较也显著升高（P均〈0.05）.通过ROC曲线分析发现,IG#、PCT及CRP的曲线下面积分别有0.833、0.758及0.716,其均有良好的判定价值,并且三个指标联合应用后可以使其在早期的肺部细菌性感染指标应用上,其敏感性及特异性分别达71.2%及86.3%.结论 IG联合PCT及CRP指标在对肺部早期细菌性感染的诊断有一定价值,而且其联合应用可以作为细菌性感染的重要评估指标.

Objective To explore the changes of immature granulocytes（IG）count,serum procalcitonin（PCT）and C reactive protein （CRP）in patients with the pulmonary infectious disease,and its early application value. Methods The total number of white blood cells（WBC）, The percentage of neutrophil（NE%）,The percentage of IG（IG%）and The absolute count of IG（IG#）were performed by Sysmex XN-1000 hematology analyzer;and the levels of PCT and CRP were measured by immune fluorescence analyzer in 200 patients with pulmonary infection and 30 cases of healthy controls . Grouped the patients with pulmonary infection by the clinical characteristics and bacterial culture results,the bacterial infection group and the non-bacterial infection group,then the changes of the parameters level among the groups were compared. Results Compared to healthy controls,The WBC,NE%,IG%,IG#,PCT and CRP levels of the bacterial infection group and the non-bacterial infection group of were significantly higher（P〈0.05）. And the above parameters level in the bacterial infection group were statistically higher compared with the non-bacterial infection group（P〈0.05）. By the receiver operating characteristic（ROC）curve analysis,the area under the curve of IG#、PCT and CRP were 0.833、0.758 and 0.716,the combined three parameters in the early diagnosis application of the pulmonary bacterial infection,with a sensitivity of 71.2% and a specificity of 86.3%. Conclusions The combined parameters with the IG、PCT and CRP in the early diagnosis of pulmonary bacterial infections have a certain significance,and they can be used as important indicators for the bacterial infection.