摘要
目的分析中性粒细胞体积参数(MNV)在机体应激状态时的变化,探讨其诊断应激状态并发败血症的可能。方法使用Coulter LH 750血液分析仪,检测66例经细菌培养确诊并发术后感染者和162例术后无感染症状者及300例正常对照者的外周血,记录白细胞计数(WBC)、中性粒细胞百分比(NE%)和MNV,再进行指标的组间比较分析。结果术后无症状组、术后局限感染组、败血症组三组术前WBC、NE、MNV和PCT结果差异无统计学意义(P>0.05),创伤应激状态下,三组WBC、NE%和MNV均高于健康人对照组(P<0.05)。术后第3天MNV及PCT在三组间都出现了显著性变化(P<0.01),而WBC、NE%未出现显著性差异(P>0.05)。术后第3天MNV与PCT具有较好的相关性(r=0.816,P<0.05)。术后第3天MNV和PCT的ROC曲线下面积分别为0.885、0.891,要大于其他指标;在取临界值≥154.85 fl和≥13.0 mg/L时,灵敏度为90.66%和83.50%,特异度为87.31%和95.50%。结论继发的细菌感染引起了应激状态下MNV参数的显著性变化,其对临床诊治术后败血症有一定帮助。
Objective To estimate the prognostic value of mean neutrophil volume for postoperative septicemia in severe head injury patient. Methods The cases included 300 controls, 162 patients without postsurgical infection, and 66 with infection. The peripheral blood samples from the patients with severe head injury were collected before operation and on the day of operation and the 2nd, 3rd day after operation. The count of white blood cell（WBC）, percentage of neutrophil（NE%）, mean neutrophil volume（MNV） and PCT were measured respectively. The patients complicated with postoperative bacterial infection were compared with those without postoperative infection. Then the localized infection patients were also compared with septicemia. The receiver-operating characteristics（ROC） curve was analyzed to estimate the possibility of postoperative bacterial infection. Results The values of WBC, NE% and MNV in the infected patients before operation and postsurgical second day had not significantly change compared with the uninfected patients（P〈0.05）. As all know, they all were higher than control＇s in stringent state（P〈0.05）. There were significant differences of MNV and PCT between the infected and uninfected patients on the third day after operation（P〈0.01）. MNV and PCT had good correlation in septicemia patient（r=0.816, P〈0.05）. By analysis of ROC curve, the AUC of MNV and PCT for the auxiliary diagnosis of infection after operation was 0.885 and 0.891. A MNV cutoff of 154.85 fl and PCT cutoff of 13.0 mg/L produced 90.66% and 83.50% sensitivity and 87.31% and 95.50% specificity, respectively, which was superior to the other leucocyte parameters. Conclusion The MNV value on the third day after operation may present certain significance for clinical monitoring of postoperative septicemia.
出处
《中华临床医师杂志（电子版）》
CAS
2016年第3期317-320,共4页
Chinese Journal of Clinicians(Electronic Edition)
基金
南通市卫生局青年基金(WQ2014011)
关键词
败血症
中性粒细胞体积参数
术后感染
Septicemia
Neutrophil volume
Postoperative bacterial infection
