92例新冠肺炎病毒感染患者早期外周血白细胞形态分析

Morphological Analysis of Early Peripheral Blood Leukocytes in 92 Patients with New Coronary Pneumonia

目的探讨新型冠状病毒肺炎(COVID-19)患者早期外周血白细胞分类和形态特征。方法对2020年1月26日~2月28日咸宁市第一人民医院收治的92例COVID-19患者及同期收治的259例其他病毒导致的病毒性肺炎(非COVID-19)患者一般情况比较、血白细胞分类和形态分析。结果与非COVID-19组相比,COVID-19组男性比例偏高,年龄偏大,胸部CT病毒性肺炎表现比例偏高,差异均有统计学意义(χ2或t为7.027~21.551,均P<0.05)。COVID-19组中性粒细胞比率(NEU%)为66.00%(62.00%和69.50%),中性粒细胞杆核比率(Nst%)31.00%(20.00%和39.00%);嗜酸性粒细胞比率(EOS%)0%(0%和1.00%);淋巴细胞比率(LYM%)22.50%(15.00%和27.00%);异形淋巴细胞比率(异淋%)0%(0%和1.00%);中性粒细胞杆核与分叶核之比(Nst/Nsg)2.26(0.44和6.06).与非COVID-19组相比,COVID-19组异淋%,NEU%,Nst%和Nst/Nsg较高,EOS%和LYM%较低,差异均有统计学意义(t为4.037~61.209,均P<0.05)。COVID-19组白细胞间接计数较低,NEU,EOS,LYM,异淋和MONO形态异形多样且明显。结论COVID-19组外周血白细胞分类和形态变化明显,在早期鉴别诊断价值较高,值得推广。

Objective To investigate the classification and morphological characteristics of early peripheral blood leukocytes in patients with new coronavirus pneumonia(COVID-19).Methods The blood of 92 patients with COVID-19 treated by the First People’s Hospital of Xianning City from January 26 to February 28,2020 and 259 patients with viral pneumonia(non-COVID-19)caused by other viruses during the same period,WBCs were classified and morphologically analyzed.Results 92 cases of covid-19 were mostly middle-aged and old men,and the manifestations of chest CT virus pneumonia were earlier,the differences were statistically significant(χ2/t was 7.027~21.551,all P<0.05).The neutrophil ratio(NEU%)was 66.00%(62.00%and 69.50%),the rod nucleus of neutrophils ratio(NST%)was 31.00%(20.00%and 39.00%),the eosinophil ratio(EOS%)was 0%(0%and 1.00%),the lymphocyte ratio(LYM%)was 22.50%(15.00%and 27.00%),the heteromorphic lymphocyte ratio(isolymph%)was 0%(0%and 1.00%),and the neutrophil stem cell ratio(NST/NSG)was 2.26(0.44 and 6.06).Compared with the noncovid-19 group,the%of NST%,NST%,NST/NSG and allolymph in the covid-19 group was higher,while the%of lym and EOS in the covid-19 group was lower(t=4.037~61.209,all P<0.05).In patients with covid-19,the morphology of leukocyte changed obviously,the cell body of lymphocyte was small,the nucleus was easy to see notch,and the majority of them were petal nuclear lymph and fissure nuclear lymph.Conclusion In the covid-19 group,the classification and morphological changes of peripheral blood leukocytes were obvious,which had high value in early differential diagnosis and was worth popularizing.