未成熟粒细胞在新生儿细菌性感染疾病诊断中的应用价值

Diagnostic Significance of Monitoring Immature Granulocytes in Newborns with Bacterial Infections

目的探讨检测未成熟粒细胞在新生儿细菌性感染疾病诊断中的作用及新生儿外周血未成熟粒细胞的正常参考值。方法选取河北北方学院附属第一医院2017年1月至2017年6月间出生的非感染新生儿50例和细菌性感染新生儿43例,采集静脉血液检测白细胞(WBC)、未成熟粒细胞(IG#、IG%)、血浆降钙素原(PCT)和C反应蛋白(CRP),运用受试者工作特征曲线(ROC曲线)进行分析。结果细菌性感染新生儿血液中WBC、IG#、IG%、PCT和CRP含量均显著高于非感染新生儿,非感染组新生儿血液标本IG#含量超过0.06(109/L)的比值为44%,IG%超过0.8%的比值为40%。检测未成熟粒细胞诊断新生儿细菌性感染的曲线下面积(AUC)分别为0.746、0.738,cut-off值为0.12、1.15时,敏感度为0.70、0.63,特异性为0.78、0.84,约登指数为0.48、0.47,阳性似然比为3.18、3.94,阴性似然比为0.38、0.44。结论未成熟粒细胞是诊断新生儿细菌性感染疾病的理想检测指标,成人未成熟粒细胞的正常参考值不适用于新生儿。

Objective To explore the role of monitoring immature granulocytes（ IG） in newborns with bacterial infections and to analyze the normal reference value of IG in peripheral blood of newborns.Methods Peripheral blood samples were collected from newborns in The First Affiliated Hospital of Hebei North University from January to June 2017,and we selected newborns with bacterial infection（ n = 43）and newborns without bacterial infection（ n = 50） to test the leukocyte（ WBC）,the absolute and percentage number of immature granulocyte（ IG# and IG%）,procalcitonin（ PCT） and C-reactive protein（ CRP）. Then we drew the receiver operating characteristic curve（ ROC curve） for analysis. Results Thelevels of WBC,IG#,IG%,PCT and CRP in newborns with bacterial infection were significantly higher than newborns without bacterial infection. In newborns without bacterial infection,forty-four percent of newborns have IG# over 0. 06（ 109/L） and fortypercent of newborns have IG% over 0. 8. The area under curve（ AUC） of IG# and IG% were 0. 746,0. 738,respectively. When the cut-off values of IG # and IG% were presented as follows： 0. 12,1. 15,sensitivity values were 0. 70,0. 63,specificity values were0. 78,0. 84,youden index were 0. 48,0. 47,positive likelihood ratio were 3. 18,3. 94 and negative likelihood ratio were 0. 38,0. 44. Conclusion Immature granulocyte could be a useful indicator for diagnosing bacterial infection diseases in newborns,but use of adult normal reference value of IG would not be appropriate for newborns.