外周血白细胞计数、淋巴细胞百分比和C-反应蛋白与呼吸道病毒检出率的相关性

目的回顾性分析外周血白细胞计数（WBC）、淋巴细胞百分比（LYN%）和C-反应蛋白（CRP）与呼吸道病毒检出率的相关性。 方法收集2016年11月至2017年12月首都医科大学附属北京地坛医院收治的103例呼吸道感染者自动巢式多重聚合酶链式反应（PCR）系统呼吸道病毒检测结果、一般资料、临床和其他实验室资料，根据患者病毒检出情况分为未检出组和检出组，对两组患者的病原学和WBC、LYN%、CRP进行统计学分析。 结果103份鼻咽拭子标本中呼吸道病毒检出率为62.14%（64/103），其中甲型流感病毒检出阳性率最高，为26.21%（27/103）；检出组患者咳嗽例数显著多于未检出组（χ² = 12.898、P < 0.001），发病天数少于未检出组（t =－2.727、P = 0.008），CRP水平低于未检出组（t =－1.897、P = 0.016）；根据C-反应蛋白值将患者分为3组：≤ 10 mg/L组、10～50 mg/L组和> 50 mg/L组，各组患者病毒检出率差异有统计学意义（χ² = 10.448、P = 0.005），其中C-反应蛋白≤ 10 mg/L组病毒检出率最高，为77.50%（31/40）；受试者工作特征曲线（ROC）分析发现WBC、LYN%和CRP曲线下面积分别为0.565、0.593和0.678，当CRP的Cut-off值为18.2 mg/L时，敏感度和特异度分别为73.3%和64.2%。 结论通过自动巢式多重PCR可检出多种呼吸道病毒。当呼吸道感染者早期表现以咳嗽、发热为主，或WBC、LYN%、CRP水平均不高时呼吸道病毒检出的可能性高，可进一步选择自动巢式多重PCR进行呼吸道病毒检测。

Correlation of peripheral white blood cell,lymphocyte percentage and C-reactive protein with the detection rate of respiratory viral pathogens

ObjectiveTo investigate the correlation between the detection rate of respiratory viral pathogens with automated nested multiplex PCR system and the infectious indexes such as peripheral white blood cell (WBC), lymphocyte percentage (LYN%) and C-reactive protein (CRP), retrospectively. MethodsFrom November 2016 to December 2017, a total of 103 nasopharyngeal swabs and clinical data from patients with respiratory infection were collected in Beijing Ditan Hospital, Capital Medical University. The pathogens were detected by automated nested multiplex PCR system, and the results was statistically analyzed. ResultsThe rate of detection among 103 nasopharyngeal swabs was 62.14% (64/103), and influenza virus had the highest positive rate of 26.21% (27/103). Compared with the virus detected group, the number of patients with cough was significantly larger (χ² = 12.898, P < 0.001), the period was shorter (t =-2.727, P = 0.008), and the CRP level was lower (t =-1.897, P = 0.016), with significant differences. Patients were divided into three groups according to C-reactive protein value: ≤ 10 mg/L group, 10-50 mg/L group and > 50 mg/L group; the virus detection rate among groups with different CRP levels was significantly different (χ² = 10.448, P = 0.005), and the highest detection rate was 77.50% (31/40) for the group with CRP ≤ 10 mg/L. The analysis of the subjects’ working characteristics curve (ROC) showed that the area of WBC, LYN% and CRP under the curve were 0.565, 0.593 and 0.678, respectively. When the Cut-off value of CRP was 18.2 mg/L, the sensitivity and specificity were 73.3% and 64.2%, respectively. ConclusionsAutomated nested multiplex PCR system could identify multiple viral respiratory pathogens in short period. When patients with respiratory tract infection characterized by cough and fever in the early stage, or levels of WBC, LYN% and CRP were not high, respiratory tract viral infection may be detected, clinicians could furtherly choose automated nested multiplex PCR system to identify the pathogen.