急性脑出血患者早期血糖及白细胞升高的临床意义

目的:探讨急性脑出血患者早期血糖及周围血白细胞计数升高与出血量、预后的关系.方法:入选病例入院后即采外周静脉血行血糖和白细胞计数检查.结果:白细胞和血糖升高越多,预后越差,病死率也增高,白细胞、血糖升高程度与出血量无显著相关.结论:急性脑出血早期外周血白细胞及血糖升高提示病情重,疗效差,可作为临床判断预后指标之一,以期制定合理的治疗方案及改善预后有一定价值.     

脑出血患者血糖值与预后的病例分析

脑出血血糖升高患者的治疗及预后明显差于血糖正常者,已有文献报道,但对不同部位脑出血患者的血糖值变化、血糖值的动态变化与预后的关系报道较少,通过对我科1993～1996年186例脑出血患者病历进行对比分析,发现血糖值的变化与脑出血患者的出血部位及预后密切相关,现将结果报告如下。1 资料与方法1.1 本组脑出血病例186例,均无糖尿病病史,其中男126例,女60例,年龄为30～79岁血糖不同程度升高者98例(52％)与国内报道相似,血糖正常者88例,所有病例均经脑CT扫描和临床表现确诊为脑出血。1.2 全部病例的血糖值均为空腹未静脉输液时所采静脉血,按本院检验血糖正常值为6.0～6.66mmol/L,6.7mmol/L以上为     

自发性脑出血住院患者急性期血糖回顾性分析

本文探讨自发性脑出血患者急性期血糖值升高的临床意义。结果表明,血糖值与脑出血量之间明显相关,血糖升高组意识障碍发生率、死亡率及并发症发生率明显高于血糖正常组(P<0.01),近期死亡组患者血糖值和血糖异常率显著高于存活组。显示自发性脑出血急性期患者出现高血糖,出血量大、病情重、预后差、死亡率高。     

重型颅脑外伤血糖水平与白细胞变化及其对病情预后关系的研究

目的：探讨重型颅脑外伤患者血液中的血糖水平、白细胞及中性粒细胞计数与格拉斯哥（GCS）评分之间的关系并分析其和患者病情预后的关系。方法：对173例重型颅脑外伤患者外周血，检测血液中的血糖浓度、白细胞及中性粒细胞数，并按照GCS评分分为轻、中、重3组。结果：随着GCS评分的降低血液中的血糖浓度、白细胞及中性粒细胞数升高的越明显，具有明显相关性，且患者急性期时血糖浓度越高、白细胞计数越大预后就越差。结论：重型颅脑外伤后血液中的血糖浓度、白细胞及中性粒细胞数可作为判断颅脑外伤预后的一项客观指标。     

末梢血白细胞数对判断脑出血预后的价值

目的探讨末梢血白细胞数对判断脑出血预后的价值。方法对113例脑出血预后资料进行分析。结果脑出血的预后与发病年龄、血压水平无关，而与血糖水平及有无意识障碍、白细胞、中性粒细胞、临床状态有关。结论白细胞及中性粒细胞对脑出血预后有判断价值。     

影响糖尿病并发脑梗死患者近期预后的危险因素分析

目的探讨影响糖尿病并发脑梗死（DIS）患者近期预后的危险因素。方法根据临床疗效对452例DIS患者的糖尿病病程、伴发病、并发症、外周血白细胞计数、空腹血糖、血脂、尿酸、糖化血红蛋白等17个指标进行对比及回归分析。结果影响其预后的主要危险因素为神经功能缺损度、脑梗死部位和大小、伴发病、并发症、外周血白细胞计数、空腹血糖、C-反应蛋白、内皮素。结论积极处理神经功能缺损度严重、高血糖和脑干、大面积、多发性脑梗死，防治感染等并发症，可改善其预后。     

重症肺炎患者外周血细胞计数与预后

目的探讨外周血细胞计数对重症肺炎患者预后的影响。方法对呼吸内科78例重症肺炎患者根据预后分为死亡组和存活组，比较2组外周血细胞计数；采用Logistic回归模型对外周血细胞计数与重症肺炎住院病死率相关性进行分析。结果外周血白细胞数，淋巴细胞数及血小板数与预后相关（P〈0．05）；用Logistic回归方程对78例重症肺炎病例进行回顾性验证，结合外周血白细胞数、淋巴细胞数及血小板数对重症肺炎预后死亡判断的总正确率为82．1％。验证重症肺炎死亡预后的总正确率为82．1％，该方程的敏感性为69．4％，特异性为92．9％。结论外周血白细胞数、淋巴细胞数及血小板数结合分析能提高对重症肺炎患者预后预测的准确性。     

新生儿脐血早期血糖监测与干预

目的通过新生儿脐血与外周血了解正常新生儿血糖值的变化,及时发现新生儿低血糖,并进行干预;同时探讨新生儿脐血快速血糖值、外周血快速血糖值之间的关联性。方法选择600例妊娠期无并发症的正常分娩的足月新生儿(无窒息)病历:400例为正常组,在整个产程中未使用任何药物;200例为输液组,在产程中使用5%葡萄糖加点滴催产素(输液量>1000ml),分别检测脐血血糖与新生儿外周血血糖值。结果正常新生儿低血糖发病率为7.1%,早期干预措施效果有效(95.4%);输液组的血糖值比正常组的明显增高(p<0.05,有统计学意义),新生儿脐血血糖与外周血血糖有显著关联性(p<0.05)。结论不能忽视正常新生儿的低血糖发生率,均应早期监测早期干预;可以用新生儿脐血快速血糖替代外周血快速血糖值,无创、方便、更快捷。产程过程中母体输入葡萄糖能影响脐血血糖值,可以查新生儿外周血血糖值进一步确诊。     

脑外伤应激性高血糖动态变化与预后的关系

目的探讨脑外伤应激性高血糖动态变化与预后的关系。方法收集三个时间段检测脑外伤住院患者的血糖值,按照患者的预后分为痊愈、好转与死亡三组,对血糖结果进行统计学分析。结果①三种预后的第一次血糖值与对照组比较存在显著性差异;②痊愈组的第二次、第三次血糖值与对照组比较无显著性差异。而好转组与死亡组第二次、第三次血糖值与对照组比较存在显著性差异;③同组比较,痊愈组血糖显著性降低,死亡组血糖显著性升高,好转组血糖下降缓慢。结论测定血糖值有利于判断脑外伤的严重程度和预后,持续性高血糖可加重患者的病情,增加临床死亡率。     

手足口病预后因素的因子分析及预后预测模型

目的 了解手足口病的预后因素并建立预后预测模型。方法 收集2009—2016年在郑州市某医院住院的478例手足口病资料,用因子分析提取预后因素的公因子,用logistic回归建立基于因子得分的预后预测模型。结果 共提取5个公因子,累计方差贡献为86.65%。因子1包括外周血中性粒细胞计数和淋巴细胞比例,因子2包括外周血白细胞计数和血小板计数,因子3包括收缩压和发热持续时间,因子4为C反应蛋白,因子5为空腹血糖。预后预测模型为P＝1/[1＋e^{-(0.0673X1+0.3126X2+0.0136X3+0.6502X4+0.2083X5+0.4080X6-0.3302X7+0.4257X8-3.043)}]。结论 基于因子分析的logistic回归模型能较好预测手足口病预后,应关注预后因素,以便做好预警和及时治疗工作。     

外周血白细胞与高脂血症的关联性：一项孟德尔随机化和观察性研究

目的 探究外周血白细胞及分类计数与血脂间的关联,旨在为高脂血症的防控提供依据。方法 回顾性分析2017—2020年于某医院进行健康体检者的资料。采用限制性立方样条模型拟合外周血白细胞及分类计数与血脂间的剂量-反应关系。基于全基因组关联研究(Genome-wide association study, GWAS)的汇总数据,运用两样本孟德尔随机化探究白细胞分类计数与血脂指标间的因果关联。采用白细胞分类计数相关的遗传位点作为工具变量,使用逆方差加权、MR-Egger回归和加权中位数法进行孟德尔随机化分析;采用异质性检验、多效性检验和逐个剔除检验进行敏感性分析。结果 共纳入18 647例体检者进行横断面分析,高脂血症患病率为42.70%,且患者的白细胞及分类计数均高于非高脂血症者(P<0.05)。白细胞及分类计数增加可导致高脂血症患病风险增加(P<0.05);且与总胆固醇、低密度脂蛋白胆固醇和甘油三酯升高有关(单核细胞、中性粒细胞和嗜酸性粒细胞除外),与高密度脂蛋白胆固醇降低有关(P<0.05)。遗传预测的淋巴细胞与低密度脂蛋白胆固醇(OR=1.04, 95%CI:1.01...     

吸烟、白细胞计数与男性放射工作人员血清胆红素水平的关联性

目的 分析吸烟、白细胞计数与男性放射工作人员血清胆红素水平的关联性,探讨机体炎症反应在吸烟对血清胆红素水平影响中的作用机制.方法 基于某医疗机构对1320名男性放射工作人员在岗或离岗时的职业健康检查数据,利用线性回归分析方法分别分析吸烟与白细胞计数、吸烟与血清胆红素水平、白细胞计数与血清胆红素水平之间的关联性.结果 吸...     

职业性苯暴露工人外周血白细胞的变化

目的了解职业性苯暴露工人外周血白细胞潜在的变化规律。方法抽取某石油化工厂1049名苯暴露工人静脉抗凝血与另一非苯暴露工人841例静脉抗凝血，对白细胞记数按差值为0．5×10^9／L分段对比分析；另在白细胞偏低者休养前后再进行对比分析。结果苯暴露工人外周血白细胞低于4．5×10^9／L的人数比对照组要多（P〈0．05），多集中在（3．5—4．0）×10^9／L之间（P〈0．05）；苯职业病检查白细胞偏低者在休养后白细胞可明显提高。结论对苯作业人员进行职业健康监护时对外周血白细胞在（3．5～4．0）×10^9／L的工人应进行早期干预；其中休养也是很好的防治手段。     

White blood cell count and risk for all-cause, cardiovascular, and cancer mortality in a cohort of Koreans

The authors conducted a 10-year prospective cohort study of mortality in relation to white blood cell counts of 437,454 Koreans, aged 40-95 years, who received health insurance from the National Health Insurance Corporation and were medically evaluated in 1993 or 1995, with white blood cell measurement. The main outcome measures were mortality from all causes, all cancers, and all atherosclerotic cardiovascular diseases (ASCVD). Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards models with adjustment for age and potential confounders. During follow-up, 48,757 deaths occurred, with 15,507 deaths from cancer and 11,676 from ASCVD. For men and women, white blood cell count was associated with all-cause mortality and ASCVD mortality but not with cancer mortality. In healthy nonsmokers, a graded association between a higher white blood cell count and a higher risk of ASCVD was observed in men (highest vs. lowest quintile: hazard ratio = 2.10, 95% confidence interval: 1.50, 2.94) and in women (hazard ratio = 1.35, 95% confidence interval: 1.17, 1.56). In healthy smokers, a graded association between a higher white blood cell count and a higher risk of ASCVD was also observed in men (highest vs. lowest quintile: hazard ratio = 1.46, 95% confidence interval: 1.25, 1.72). These findings indicate that the white blood cell count is an independent risk factor for all-cause mortality and for ASCVD mortality.     

The relationship of white blood cell count to other cardiovascular risk factors

Baseline data for the 12,866 men from the Multiple Risk Factor Intervention Trial was used to study factors related to white blood cell (WBC) count. White blood cell count was significantly higher in smokers (7853 cells/mm3) and ex-smokers (7091 cells/mm3) who stopped smoking less than one year before than in ex-smokers who stopped more than one year before (6255 cells/mm3) and those who never smoked (6094 cells/mm3). In current cigarette smokers, white blood cell count was significantly related to number of cigarettes smoked, degree of inhalation, and duration of smoking (p less than 0.001 for each). In addition, white blood cell count was higher in non-cigarette smokers who smoked pipes, cigars, or cigarillos than among men who did not smoke tobacco (p less than 0.001). White blood cell count was lower in blacks (by 877 cells/mm3) and Orientals (by 634 cells/mm3) than in whites. Leukocyte count also showed a strong inverse association with high density lipoprotein (HDL)-cholesterol, a positive association with triglycerides independent of cigarette use, and a positive association with low density lipoprotein (LDL)-cholesterol in smokers only. Leukocyte counts were inversely related to total family income and alcohol consumption. We conclude that elevated leukocyte count is independently associated with other risk factors for coronary heart disease (CHD) such as amount and duration of smoking as well as an atherogenic profile, and these relationships should be considered when using white blood cell count as a predictor of coronary heart disease.     

儿童hsCRP、白细胞计数和中性粒细胞比例在感染中的意义

目的:通过分析呼吸道感染患儿的超敏C-反应蛋白(hsCRP)、白细胞计数(WBC)及性粒细胞比值(N%)的检测结果,探讨hsCRP、WBC及N%在患儿感染中的临床意义和相关性。方法:回顾性分析1 196例该院2011年收治的呼吸道感染患儿,根据患儿感染的病原体分为细菌组、病毒组及支原体组,同时选择200例该院健康体检儿童为对照组,检测并比较各组hsCRP、WBC、hsCRP、N%。结果:统计分析显示,细菌组患儿的hsCRP、WBC及N%均显著升高,且多数情况下为hsCRP、WBC、N%同时升高或hsCRP升高伴WBC或N%升高,尤其以N%与hsCRP的相关性更明显;病毒组患儿的N%显著下降,hsCRP及WBC均正常;支原体感染患儿的hsCRP、WBC及N%升高不明显,多数为hsCRP、WBC、N%中一至两项轻度升高;在分层研究中,细菌组和支原体感染组N%和hsCRP呈正相关,高于WBC和hsCRP的相关性。结论:在呼吸道感染患儿中,联合检测hsCRP、WB、N%可有效鉴别细菌、病毒及支原体感染,进而指导临床治疗,尤其hsCRP与N%同时明显升高提示细菌感染,应根据病情及早选用有效的抗生素进行治疗。     

利用相似接触组研究低浓度苯接触对工人血液指标的影响

目的　研究不同相似接触组 (SEG)工人的血液指标与苯的接触剂量的关系。方法　研究对象为某鞋厂成型车间的制鞋工人 ,采用观察法和采样法相结合的方法划分SEG ,个体采样泵采集每个SEG中 5个工人呼吸带处接触水平 ,体检收集工人的血样、职业史 ,多元回归分析苯的接触水平对血常规的影响。结果　根据SEG的定义及该车间的实际情况 ,划分为 5个SEG ,除年龄有差异外 ,各SEG工人的工龄、吸烟、饮酒、血常规、主诉症状方面差异无显著性 (P >0 .0 5 ) ;多元回归分析发现 ,外周血白细胞计数随空气中苯浓度的增加而减少 ,两者之间呈负相关 (r=- 0 .36 ,P <0 .0 5 ) ;接苯工龄与红细胞计数也存在负相关 (r =- 0 .2 9,P <0 .0 5 ) ;而红细胞和血小板的计数与苯接触之间没有发现类似的相关关系 (P >0 .0 5 )。结论　SEG研究发现 ,苯的接触剂量与白细胞计数之间存在剂量 -反应关系 ,今后应该通过增加样本量 ,进一步研究低浓度的苯接触对工人外周血液指标的影响。     

Variation and information in white blood cell differential counts

The magnitude and sources of variation in the white blood cell (WBC) count and differential count affect their information content and clinical value. This study describes components of variation in the WBC count and differential, estimates the magnitude of each component, and uses computer simulations to compare the information conveyed by the total WBC count and by the WBC differential count, expressed as the number of each type of cell and as the percentage of each cell type. Biologic variation is much greater than statistical sampling variation in differential WBC counts, even when a relatively small number of cells is classified. The commonly reported neutrophil percentage is inferior both to the neutrophil count and to the total WBC count in its ability to detect neutrophilia and to detect recovery from elevated levels. This conclusion holds for single as well as for sequential WBC differential determinations and regardless of the level of test result at which the clinician considers disease to be present. The total WBC count and the neutrophil count differ little in performance, so a neutrophilic patient's return to normal levels can safely be detected and monitored by relying on the less expensive total WBC count and foregoing repeated requests for differential counts.     

Assessment of complete blood count variations among workers exposed to low levels of benzene.

The effect of benzene on white blood cell and red blood cell counts, hemoglobin level, mean corpuscular volume (MCV), and platelet count was investigated among workers in a small petroleum company. The investigated cohort consisted of 105 workers exposed to low levels of benzene between 1967 and 1994. The average level of benzene exposure per year ranged between 0.14 parts per million and 2.08 parts per million (8-hour time-weighted average). The mean complete blood count (CBC) demonstrated values within normal ranges. With the exception of white blood cells, all other CBC values were significantly reduced during the follow-up period. Length of employment was significantly related to the changes in MCV and platelet counts. The reductions in MCV were significant only among workers who had been employed for more than 10 years at this particular company. The findings of this study suggest that low levels of benzene may affect CBC values. CBC values may serve as a useful tool for biological monitoring for workers with low-level benzene exposure.