基础医学与临床 ›› 2017, Vol. 37 ›› Issue (7): 1000-1003.

• 研究论文 • 上一篇    下一篇

中性粒细胞/淋巴细胞比值对血流感染的诊断价值

申丽红1,陈永德1,朝浩鹏1,宋文琪2,田晓怡2   

  1. 1. 中国中医科学院望京医院
    2. 首都医科大学附属北京儿童医院
  • 收稿日期:2017-03-10 修回日期:2017-04-24 出版日期:2017-07-05 发布日期:2017-06-23
  • 通讯作者: 田晓怡 E-mail:xiaoyitianpumc@163.com
  • 基金资助:
    首都医科大学附属北京儿童医院苗圃计划

Value of neutrophil-lymphocyte count ratio in diagnosing bloodstream infection

  • Received:2017-03-10 Revised:2017-04-24 Online:2017-07-05 Published:2017-06-23

摘要: 目的 探讨5项感染标志物对血流感染的诊断价值。方法 随机选取望京医院血培养阳性的血流感染患者110例为研究组,血培养阴性的细菌感染患者30例为对照组。在血培养的同1天抽取静脉血,检测全血细胞计数和C反应蛋白(CRP)。比较两组白细胞(WBC)、中性粒细胞(NEU)、淋巴细胞(LYM)、中性粒细胞/淋巴细胞比值(NLCR)和CRP的差异。结果 血流感染组WBC、NEU、NLCR、CRP均显著高于对照组(P<0.05),而LYM显著低于对照组(P<0.05)。5项感染标志物中,NLCR和LYM诊断血流感染的受试者工作特征曲线下面积(ROC-AUC)分别为0.808和0.756。当NLCR取临界值为9.33时,敏感性为63.6%,特异性为93.3%;LYM小于等于0.97为临界值时,敏感性为58.2%,特异性为86.7%。进一步,在血培养阳性患者中,革兰氏阴性菌所致的血流感染组的NLCR高于革兰氏阳性菌血流感染组,NLCR在区分血流感染的类型中具有重要的临床意义。结论 NLCR优于其他常规感染指标,有助于血流感染的诊断。

关键词: 中性粒细胞/淋巴细胞比值, 血流感染

Abstract: Objective To explore the diagnostic value of five infection markers in bloodstream infection. Methods Randomly selected 110 bloodstream infection patients with positive blood cultures and 30 bacterial infection patients with negative blood cultures. Blood were drawn simultaneously with blood cultures; the complete blood count and C-reactive protein (CRP) levels were measured. The white blood cell count(WBC), neutrophil count (NEU), lymphocyte count (LMY), CRP level and neutrophil-lymphocyte count ratio (NLCR) were compared between the two groups. Results The levels of WBC, NEU, NLCR and CRP in bloodstream infection group were significantly higher than those in control group (P <0.05), while LYM was significantly lower than that in control group (P <0.05).Among these five infection markers, the area under the receiver operating characteristic curve (ROC-AUC) was the highest for NLCR (0.808) and LMY (0.756); when the cutoff value for NLCR was >9.33, sensitivity was 63.6%, specificity was 93.3%; and the cutoff value for LYM was ≤0.97, sensitivity was 58.2%, specificity was 86.7%. Furthermore, the NLCR of patients with gram-negative bloodstream infection was higher than those in patients with gram-positive bloodstream infection. NLCR showed important clinical significance in distinguishing strains of different bloodstream infections. Conclusion NLCR is the better predictors than routine parameters in diagnosing bloodstream infection.

Key words: neutrophil-lymphocyte count ratio, bloodstream infection

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