中性粒细胞VCS参数在呼吸系统细菌感染性疾病中的变化及临床应用

目的通过检测呼吸系统细菌感染患者的中性粒细胞参数VCS的变化，探讨其临床应用价值。方法利用全自动血细胞分析仪的细胞体积、高频电流传导、激光散射（VCS）技术，测定50例健康者（对照组）和60例确诊细菌感染患者（感染组）WBC计数、中性粒细胞百分比（percentageofneu-trophil，NE％）、中性粒细胞VCS参数及其各自标准差（standarddeviation，SD）。同时检测C反应蛋白（Creactionprotein，CRP），并对检测结果进行统计学分析。结果感染组患者WBC、NE％、V、V-SD、C、CRP检测水平均高于对照组，且差异均有统计学意义（P均〈0．05）。感染组2中WBC、NE％、V-SD、CRP检测水平均高于感染组1，且差异均有统计学意义（P均〈0．05）。感染组患者C-SD、S、S-SD检测水平与对照组比较差异均无统计学意义（P均〉0．05）。根据受试者工作特征（receiveroperatingcharacteristic，ROC）曲线判断WBC、NE％、CRP、V及V-SD的cutoff值分别为8．4xlOg／L、70％、6．6mg／L、144和20．45。其中NE％＋CRP、WBC＋CRP＋V-SD、NE％＋CRP＋V-SD三种组合诊断细菌感染的灵敏度、特异性均高于80％。ROC曲线表明CRP、NE％诊断细菌感染效能优秀，曲线下面积（areaundercure，AUC）分别为0．89、0．87，V及V-SD一般，AUC^ROC分别为0．75、0．74，而WBC诊断效能最差，AUC^ROC为O．67。结论呼吸系统细菌感染患者的中性粒细胞体积参数V及V-SD变化较为灵敏，与WBC、NE％和CRP联合诊断时可明显提高灵敏度，同时WBC、NE％和CRP有较好特异性，可为临床判断呼吸系统细菌感染起到很好的提示作用。

The value and clinical application of the determination of neutrophil VCS parameters in the diagnosis of respiratory system infectious diseases

Objective To detect the changes and explore the clinical significance of the neutrophil VCS parameters in the patients with respiratory system infectious diseases. Methods 50 normal persons（con- trol group） and 60 patients with diagnosed respiratory system infections （infected group） were selected in this study. Data included total WBC counts, percentage of neutrophil （NE%）, the VCS parameters and standard deviation （SD） of neutrophil, were measured by the automatic blood cell analyzer. C reactive protein （CRP） was measured simuhaneously and the results were statistically analyzed. Results The levels of WBC, NE%, V, V-SD, C and CRP in infected group were all higher than in control group, and the differences all had statistical significance （Pall〈 0.05）. The levels of WBC, NE%, V-SD and CRP in infected group 2 were all higher than in infected group 1, and the differences all had statistical significance （Pall〈 0.05）. There were no statistical significance in the differences of C-SD, S, S-SD levels between infected group and control group（Pall〉 0.05 ）. The cutoff vallue of WBC, NE%, CRP, V and V-SD were 8.4×109/L, 70%, 6.6 mg/L, 144 and 20.45 re- spectively according to receiver operating characteristic （ROC） curve. The sensitivity and specificity of combi- nation detection of NE%＋CRP, WBC＋CRP＋V-SD, NE%＋CRP＋V-SD were all higer than 80%. According to the ROC curve, the efficient of CRP and NE% were excellent, the area under curve （AUC） were 0.89, 0.87 respectively. V and V-SD were general, AUCROC were 0.75, 0.74, and the WBC was worse, AUCROC was 0.67. Conclusion The neutrophil V and V-SD change significantly in the patients with respiratory system infec- tions. The sensitivity and specificity are greatly improved when the combination of WBC, NE%, CRP and V/ V-SD were used and it may provide help for diagnosis of respiratory system infectious diseases.