中性粒细胞毒性指数在诊断血液系统疾病合并细菌感染中的价值研究
|
摘要
目的观察血液系统疾病合并细菌感染患者外周血中性粒细胞中毒颗粒(Toxic granulation),分析中性粒细胞毒性指数(neutrophils toxic granulation,index,TG%)及其分级水平的检测与炎症指标的相关性,探讨血液系统疾病合并细菌感染患者外周血中性粒细胞中毒颗粒检测的临床意义。方法选取2014年3月至2016年6月本院60例血液系统疾病合并细菌感染患者为合并感染组(按临床症状分为轻度感染组和中重度感染组)、104例非细菌感染患者为非合并感染组、选择同期健康者体检者50例为健康对照组;检测和比较三组的外周血TG%及分级、PCT(Procalcitonin,PCT)、CRP(C-reactive protein,CRP)、WBC(white blood cell,WBC)、中性粒细胞百分比(neutrophilic granulocyte percentage,NEUT%)水平;比较血液系统疾病合并细菌感染患者TG%与PCT、CRP、WBC、NEUT%间的相关性;同时对轻度感染组和中重度感染组患者入院治疗前、后的TG%及各炎症指标变化进行比较。结果合并感染组患者的TG%、PCT、CRP、WBC、NEUT%较非合并感染组、健康组增高,差异具有统计学意义(P<0.05);TG%与PCT(r=0.552,P<0.01)、CRP(r=0.412, P<0.01)、WBC(r=0.366, P<0.01)、NEUT%(r=0.544, P<0.01)均呈显著正相关。中重度感染组患者的TG%及分级水平、PCT和CRP水平较轻度感染组增高(P<0.05),两组患者治疗后TG%、PCT、CRP水平明显降低(P<0.05)。结论外周血TG%及分级水平可反映血液系统疾病合并细菌感染患者体内炎症水平,可作为一种炎症指标评估感染程度。
Objective Observe the neutrophil toxic granulation in the peripheral blood of patient with concurrent bacterial infection of blood system disease; analyze the neutrophil toxic index(TG%), detection of its classification level and correlation of inflammation marker; discuss the clinical significance of the detection of neutrophil toxic granulation in the peripheral blood of patient with concurrent bacterial infection of blood system disease. Methods Select 60 cases of patients with concurrent bacterial infection of blood system disease from March, 2014 to June, 2016 as the concurrent infection group(divided into mild infection sub-group and moderate to severe infection sub-group according to the clinical symptoms), 104 cases of non-bacterial infection patients as non-concurrent infection group, and 50 cases of concurrent healthy persons receiving physical examination as the healthy control group; check and compare the TG% and classification of peripheral blood, PCT(procalcitonin), CRP(C-reactive protein), WBC(white blood cell) and NEUT%(neutrophilic granulocyte percentage) level of three groups; compare the correlation between the TG% and PCT,CRP,WBC,NEUT% of patients with concurrent bacterial infection of blood system disease; in the meantime, for patients in the mild infection sub-group and moderate to severe infection sub-group, compare the change of their TG% and various inflammation markers before and after treatment. Results Compared with the patients in non-concurrent infection group and non-concurrent infection group, the TG%, PCT, CRP, WBC and NEUT% patients in concurrent infection group showed significantly increase, and the difference had statistical significance(P <0.05); TG% presented significant positive correlation with all of PCT(r =0.552, P<0.01), CRP(r=0.412, P<0.01), WBC(r=0.366, P<0.01) and NEUT%(r=0.544, P<0.01).Compared with the patients in mild infection sub-group, the TG% and classification level, PCT and CRP level of patients in moderate to severe infection sub-group all presented significantly increase(P<0.05), and for patients in both sub-groups, their TG%, PCT and CRP level showed significant decline after treatment(P<0.05). Conclusion The TG% and classification level of peripheral blood can reflect the body inflammation level of patient with concurrent bacterial infection of blood system disease,which can be used as an inflammation marker to evaluate the infection degree.
Objective Observe the neutrophil toxic granulation in the peripheral blood of patient with concurrent bacterial infection of blood system disease; analyze the neutrophil toxic index(TG%), detection of its classification level and correlation of inflammation marker; discuss the clinical significance of the detection of neutrophil toxic granulation in the peripheral blood of patient with concurrent bacterial infection of blood system disease. Methods Select 60 cases of patients with concurrent bacterial infection of blood system disease from March, 2014 to June, 2016 as the concurrent infection group(divided into mild infection sub-group and moderate to severe infection sub-group according to the clinical symptoms), 104 cases of non-bacterial infection patients as non-concurrent infection group, and 50 cases of concurrent healthy persons receiving physical examination as the healthy control group; check and compare the TG% and classification of peripheral blood, PCT(procalcitonin), CRP(C-reactive protein), WBC(white blood cell) and NEUT%(neutrophilic granulocyte percentage) level of three groups; compare the correlation between the TG% and PCT,CRP,WBC,NEUT% of patients with concurrent bacterial infection of blood system disease; in the meantime, for patients in the mild infection sub-group and moderate to severe infection sub-group, compare the change of their TG% and various inflammation markers before and after treatment. Results Compared with the patients in non-concurrent infection group and non-concurrent infection group, the TG%, PCT, CRP, WBC and NEUT% patients in concurrent infection group showed significantly increase, and the difference had statistical significance(P <0.05); TG% presented significant positive correlation with all of PCT(r =0.552, P<0.01), CRP(r=0.412, P<0.01), WBC(r=0.366, P<0.01) and NEUT%(r=0.544, P<0.01).Compared with the patients in mild infection sub-group, the TG% and classification level, PCT and CRP level of patients in moderate to severe infection sub-group all presented significantly increase(P<0.05), and for patients in both sub-groups, their TG%, PCT and CRP level showed significant decline after treatment(P<0.05). Conclusion The TG% and classification level of peripheral blood can reflect the body inflammation level of patient with concurrent bacterial infection of blood system disease,which can be used as an inflammation marker to evaluate the infection degree.
引文
[1]贾蓓,钱元恕.中性粒细胞在细菌感染中的免疫调节作用[J].国外医药抗生素分册,2004:25(2):61-63.
[2]刘成玉,罗春丽.临床检验基础[M].第5版.北京:人民卫生出版社.2011-2012.
[3]朱忠勇.实用医学检验学[M].北京:人民军医出版社.1991-1992.
[4]洪骏,唐海霞,戴雯,等.中性粒细胞中毒颗粒与降钙素原联合检测对细菌性肺炎诊断的意义[J].东南国防医药,2015,2(17):14-148.
[5]张之南,沈悌.血液病诊断及疗效标准[M].北京:科学出版社,1999.78-85.
[6]殷大奎,于宗河,王羽.临床医院感染学[M].修订版.湖南科技大学出版社.2005:182-183.
[7]叶应妩,王毓三,申子瑜.全国临床检验操作规程[M].第3版.南京:东南大学出版社.2006.123-124.
[8]邵表,沈定霞.造血干细胞移植后侵袭性真菌感染的诊断和治疗进展.[J].中国实验血液学杂志,2009.17(6):1619-1623.
[9]赵满仓,范永谦.降钙素原和超敏C反应蛋白检测在诊断新生儿感染性疾病中的临床价值[J].国际检验医学杂志,2013,34(17):2326-2327.
[10]邹新妍,张丽.血清降钙素原及超敏C反应蛋白检测在新生儿感染性黄疸诊断中的应用价值[J].实验与检验医学,2018,36(2):204-206.
[11]血清降钙素原检测在对诊断老年性心力衰竭合并肺部感染的临床应用价值[J].实验与检验医学,2018,36(2):225-227.
[12]刘文超,杨桂强.血液病血流感染患者血培养与血清降钙素原定量结果的关联性分析[J].中国医药指南,2013,18(30):115-116.
[13]万岁桂,郑程程,韩旭等.中性粒细胞CD64指数在血液病合并细菌感染诊断中的价值[J].中国实验血液学杂志,2014:22(3):797-800.
[14]蔡妍,章金灿,杨惠钿.中性粒细胞中毒颗粒与C反应蛋白的相关性研究[J]实用医学杂志,2013,19(29):3231-3234.
[15]贾蓓.钱元恕.中性粒细胞在细菌感染中的免疫调节作用[J].国外医药抗生素分册,2004,25(2):61-63.
[16]贺姝慧,赵巧莲.白细胞形态结合中性粒细胞碱性磷酸酶测定对感染诊断的意义[J].广东医学,2011,32(20):2674-2675.
[17]牛冬梅,王锋,洪骏,等.中性粒细胞中毒颗粒与炎症性贫血[J].临床检验杂志,2012,30(6):440-441.
[2]刘成玉,罗春丽.临床检验基础[M].第5版.北京:人民卫生出版社.2011-2012.
[3]朱忠勇.实用医学检验学[M].北京:人民军医出版社.1991-1992.
[4]洪骏,唐海霞,戴雯,等.中性粒细胞中毒颗粒与降钙素原联合检测对细菌性肺炎诊断的意义[J].东南国防医药,2015,2(17):14-148.
[5]张之南,沈悌.血液病诊断及疗效标准[M].北京:科学出版社,1999.78-85.
[6]殷大奎,于宗河,王羽.临床医院感染学[M].修订版.湖南科技大学出版社.2005:182-183.
[7]叶应妩,王毓三,申子瑜.全国临床检验操作规程[M].第3版.南京:东南大学出版社.2006.123-124.
[8]邵表,沈定霞.造血干细胞移植后侵袭性真菌感染的诊断和治疗进展.[J].中国实验血液学杂志,2009.17(6):1619-1623.
[9]赵满仓,范永谦.降钙素原和超敏C反应蛋白检测在诊断新生儿感染性疾病中的临床价值[J].国际检验医学杂志,2013,34(17):2326-2327.
[10]邹新妍,张丽.血清降钙素原及超敏C反应蛋白检测在新生儿感染性黄疸诊断中的应用价值[J].实验与检验医学,2018,36(2):204-206.
[11]血清降钙素原检测在对诊断老年性心力衰竭合并肺部感染的临床应用价值[J].实验与检验医学,2018,36(2):225-227.
[12]刘文超,杨桂强.血液病血流感染患者血培养与血清降钙素原定量结果的关联性分析[J].中国医药指南,2013,18(30):115-116.
[13]万岁桂,郑程程,韩旭等.中性粒细胞CD64指数在血液病合并细菌感染诊断中的价值[J].中国实验血液学杂志,2014:22(3):797-800.
[14]蔡妍,章金灿,杨惠钿.中性粒细胞中毒颗粒与C反应蛋白的相关性研究[J]实用医学杂志,2013,19(29):3231-3234.
[15]贾蓓.钱元恕.中性粒细胞在细菌感染中的免疫调节作用[J].国外医药抗生素分册,2004,25(2):61-63.
[16]贺姝慧,赵巧莲.白细胞形态结合中性粒细胞碱性磷酸酶测定对感染诊断的意义[J].广东医学,2011,32(20):2674-2675.
[17]牛冬梅,王锋,洪骏,等.中性粒细胞中毒颗粒与炎症性贫血[J].临床检验杂志,2012,30(6):440-441.