检测未成熟粒细胞在脓毒症诊断中的应用价值

The Application Value of Monitoring Immature Granulocytes in Patients with Sepsis

目的分析未成熟粒细胞(immature granulocyte,IG)在脓毒症诊断中的检测价值。方法选取河北北方学院附属第一医院2016年9月至12月间就诊健康体检人员50例、非脓毒症感染患者44例和脓毒症患者56例,抽取静脉血液标本检测未成熟粒细胞(IG#,IG%)、降钙素原(PCT)、白细胞(WBC)、中性粒细胞(NEUT)含量进行统计分析,应用受试者工作特征曲线分析检测未成熟粒细胞(IG#和IG%)在脓毒症诊断中的应用价值。结果脓毒症患者和非脓毒症感染患者血液中未成熟粒细胞(IG#,IG%)、降钙素原(PCT)、白细胞(WBC)、中性粒细胞(NEUT)含量均显著高于正常健康人员,脓毒症患者未成熟粒细胞(IG#和IG%)含量虽高于非脓毒症感染患者,但无统计学差异。检测未成熟粒细胞(IG#,IG%)诊断脓毒症的曲线下面积(area under the curve,AUC)依次为0.862、0.867,当IG#和IG%参数cut-off值为0.065、0.75时,敏感度为0.679、0.768,特异性为0.980、0.840,约登指数为0.659、0.608,阳性似然比为33.95、4.80,阴性似然比为0.33、0.28。结论检测未成熟粒细胞为脓毒症诊断监测的一个新的炎症指标,但检测未成熟粒细胞并不能用于区分患者感染的严重程度。

Objective To explore the application value of immature granulocytes（ IG） in patients with sepsis. Methods Blood samples were routinely taken from clinical patients in the First Affiliated Hospital of Hebei North University from September to December 2016. Three groups of patients have been analyzed and compared： healthy people（ n = 50）,patients with local infections（ n = 44）,and patients with sepsis（ n = 56）. The absolute and percentage number of immature granulocyte（ IG# and IG%）,procalcitonin（ PCT）,leukocyte（ WBC） and neutrophile granulocyte（ NEUT） were analyzed,then we drew the receiver operating characteristic curve（ ROC curve） to evaluate the function of immature granulocytes in sepsis.Results Compared with healthy people,the levels of IG#,IG%,PCT,WBC and NEUT were significantlyhigher in patients with local infections and patients with sepsis. But there was no statistical difference of immature granulocytes between patients with sepsis and those with local infections. The area under curve（ AUC） of IG# and IG% were 0. 862,0. 867,respectively. When the cut-off values of IG# and IG %were presented as follows： 0. 065,0. 75,Sensitivity values were 0. 679,0. 768,Specificity values were0. 980,0. 840,Youden index were 0. 659,0. 608,and positive likelihood ratio were 33. 95,4. 80 and negative likelihood ratio were 0. 33,0. 28. Conclusion Immature granulocyte could be a new and powerful indicator for diagnosing and screening sepsis,not discrimination of infections severity.