外周血白细胞参数在局部感染和血流感染中的早期预测价值

The early prediction value of peripheral blood leukocyte parameters in local infection and bloodstream infection

目的探讨外周血白细胞参数在局部感染和血流感染中的早期预测价值。方法选取2020年7月至2021年6月四川大学华西医院收治的血流感染患者131例(血流感染组)、局部感染患者97例(局部感染组)作为研究对象。另选取同期在该院进行体检的健康者99例作为健康对照组。对各组外周血白细胞参数白细胞计数(WBC)、中性粒细胞绝对值(NEUT#)、单核细胞绝对值(MONO#)、淋巴细胞绝对值(LYMP#)、嗜酸性粒细胞绝对值(EO#)、嗜碱性粒细胞绝对值(BASO#)、幼稚粒细胞绝对值(IG#)、高荧光强度大细胞绝对值(HFLC#)、中性粒细胞前向散射光强度分布宽度(NE-WZ)、中性粒细胞侧向散射光强度分布宽度(NE-WX)、中性粒细胞侧向荧光强度分布宽度(NE-WY)、淋巴细胞前向散射光强度分布宽度(LY-WZ)、淋巴细胞侧向散射光强度分布宽度(LY-WX)、淋巴细胞侧向荧光强度分布宽度(LY-WY)、单核细胞侧向荧光强度分布宽度(MO-WY)、单核细胞侧向散射光强度分布宽度(MO-WX)、单核细胞前向散射光强度分布宽度(MO-WZ)结果进行组间比较,分析其与降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白(CRP)之间的相关性,并采用受试者工作特征曲线评估白细胞参数早期预测局部感染和血流感染的诊断效能。结果局部感染组与血流感染组WBC、NEUT#、LYMPH#、MONO#、IG#、HFLC#、NE-WX、NE-WY、NE-WZ、LY-WX、LY-WY、LY-WZ、MO-WX、MO-WZ与健康对照组比较,差异有统计学意义(P<0.05)。局部感染组MONO#、HFLC#高于血流感染组,局部感染组NE-WX、NE-WY、NE-WZ、LY-WX、LY-WY、LY-WZ、MO-WX、MO-WZ低于血流感染组,差异有统计学意义(P<0.05)。相关性分析显示,NE-WY与IL-6、PCT呈正相关(P<0.05),LYMPH#、MONO#、LY-WX、MO-WX、MO-WY、MO-WZ与IL-6、PCT呈负相关(P<0.05)。NE-WX、NE-WY、LY-WY、LY-WZ、MO-WX对局部感染与血流感染的鉴别诊断效能较优。结论白细胞参数具有较好的早期预测局部感染和血流感染的价值,可辅助提高临床对其感染诊断效能。

Objective To investigate the early prediction value of peripheral blood leukocyte parameters in local infection and bloodstream infection.Methods 131 patients with bloodstream infection(bloodstream infection group)and 97 patients with local infection(local infection group)admitted to West China Hospital,Sichuan University from July 2020 to June 2021 were selected as the research objects.Another 99 healthy subjects who underwent physical examination in the same period were selected as healthy control group.White blood cell count(WBC),neutrophil count/absolute concentration(NEUT#),monocyte count/absolute concentration(MONO#),lymphocyte count/absolute concentration(LYMP#),eosinophil count/absolute concentration(EO#),basophil count/absolute concentration(BASO#),immature granulocyte absolute count(IG#),high fluorescence larger cell absolute concentration(HFLC#),forward scatter intensity distribution width of neutrophil(NE-WZ),side scatter intensity distribution width of neutrophil(NE-WX),side fluorescence intensity distribution width of neutrophil(NE-WY),forward scatter intensity distribution width of lymphocyte(LY-WZ),side scatter intensity distribution width of lymphocyte(LY-WX),side fluorescence intensity distribution width of lymphocyte(LY-WY),side fluorescence intensity distribution width of monocyte(MO-WY),side scatter intensity distribution width of monocyte(MO-WX),forward scatter intensity distribution width of monocyte(MO-WZ)were compared between groups.The correlation between them and procalcitonin(PCT),interleukin-6(IL-6)and C-reactive protein(CRP)was analyzed,and evaluated the diagnostic efficacy of leukocyte parameters in early prediction of local infection and bloodstream infection by receiver operating characteristic curve.Results WBC,NEUT#,LYMPH#,MONO#,IG#,HFLC#,NE-WX,NE-WY,NE-WZ,LY-WX,LY-WY,LY-WZ,MO-WX,MO-WZ of local infection group and bloodstream infection group were compared with healthy control group,and the differences were statistically significant(P<0.05).MONO#and HFLC#in the local infection group were higher than those in the bloodstream infection group,while NE-WX,NE-WY,NE-WZ,LY-WX,LY-WY,LY-WZ,MO-WX and MO-WZ in the local infection group were lower than those in the bloodstream infection group,the difference was statistically significant(P<0.05).Correlation analysis showed that NE-WY was positively correlated with IL-6 and PCT(P<0.05),and its correlation with LYMPH#,MONO#,LY-WX,MO-WX,MO-WY,MO-WZ was negatively correlated with IL-6 and PCT(P<0.05).NE-WX,NE-WY,LY-WY,LY-WZ,MO-WX have better differential diagnosis efficiency for local infection and bloodstream infection.Conclusion Leukocyte parameters have a good early prediction value in local infection and bloodstream infection,which can help improve the clinical diagnostic efficiency of its infection.