中性粒细胞VCS参数在细菌感染性疾病早期诊断及疗效中的应用价值

目的探讨中性粒细胞（NE）体积（V）、电导率（C）及激光散射值（S）等参数在细菌感染性疾病诊断及疗效观察中的应用价值。方法利用Beckman Coulter LH 750全自动血液分析仪VCS技术检测108例急性细菌感染性疾病患者及96例健康体检者的外周血标本,统计分析白细胞（WBC）总数、和中性粒细胞体积（NEV）、浆核比例（NEC）、胞浆颗粒特性（NES）及NE的体积分布宽度（NDW）。将细菌感染组根据WBC高低分成A、B和C 3组;根据NE百分率分为NE≤80%组和NE〉80%组;观察69例细菌感染组患者治疗前后VCS参数变化。结果与健康对照组比较,细菌感染组患者的NEV、NDW明显增高（P〈0.01）,NES明显降低（P〈0.01）,NEC则无明显变化;A组、B组、C组、NE≤80%组和NE〉80%组的NEV、NDW均明显高于健康对照组（P〈0.05,P〈0.01）,NES则均明显降低（P〈0.05,P〈0.01）;69例细菌感染组患者治疗后的NEV、NDW和NES与治疗前比较,差异均有统计学意义（P〈0.01）,与对照组比较无统计学意义。结论细菌感染早期（包括WBC未升高时）外周血NEV、NDW升高,NES下降,感染好转时NEV、NDW降低,NES升高,监测NE的VCS参数对急性细菌感染性疾病早期诊断及疗效观察有重要临床价值。

The value of neutrophil VCS parameters in early diagnosis and evaluation of bacterial infection

Objective To explore the diagnosis value of the neutrophil VCS（volume,conductivity and light scatter） parameters and the plasma granule in the patients with bacteria infection.Methods Using the VCS parameters of the automatic hematology analyzer（Beckman-Coulter LH 750）,the White blood cell count（WBC）,the neutrophil＇s volume（NEV）,plasma-nucleus＇s ratio（NEC）,plasm granule＇s characteristic（NES）,the neutrophil＇s Volume distribution width（NDW）of 108 patients with bacteria infection and 96 normal subject were determined.The patients with bacteria infection were divided into 3 groups,group A,B,and C based on the level of WBC.Also these patients were divided into group NE ≤80% and group NE80% according to the percentage of NE.The change of VCS parameters was observed in 69 cases of bacterial infection before and after treatment.Results Compared with the healthy control group,the parameters of NEV,NDW increased significantly（P0.01）,the NES decreased significantly（P0.01）,but the NEC remain unchanged.In group A,group B,group C,group NE ≤80% and group NE 80%,NEV,NDW were significantly higher than the healthy control group（P0.05,P0.01 respectively）,but the NES in the decreased groups were significantly lower（P0.05,P0.01）;After treatment,the parameters of NEV,NDW and NES felled significantly（P0.01）,but compared with the control group,there were not statistically significant.Conclusions Early bacterial infection（including the WBC is not elevated） the NEV,NDW of blood increased,NES decreased.When the infection was controlled,NEV,NDW declined,NES increased.So the parameters of VCS may be used as an index of the severity of acute bacteria infection.