[1]任党利,韩海燕,周 鑫,等.中性粒细胞/淋巴细胞比值在区分不同病原菌引起血流感染的价值[J].现代检验医学杂志,2017,32(02):102-105.[doi:10.3969/j.issn.1671-7414.2017.02.028]
 REN Dang-li,HAN Hai-yan,ZHOU Xin,et al.Clinical Evaluation on Ratio of Neutrophil-to-Lymphocyte in Different Pathogens[J].Journal of Modern Laboratory Medicine,2017,32(02):102-105.[doi:10.3969/j.issn.1671-7414.2017.02.028]
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中性粒细胞/淋巴细胞比值在区分不同病原菌引起血流感染的价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年02期
页码:
102-105
栏目:
论著
出版日期:
2017-03-25

文章信息/Info

Title:
Clinical Evaluation on Ratio of Neutrophil-to-Lymphocyte in Different Pathogens
文章编号:
1671-7414(2017)02-102-04
作者:
任党利韩海燕周 鑫刘 锦靳 颖
武警后勤学院附属医院检验科,天津 300162
Author(s):
REN Dang-liHAN Hai-yanZHOU XinLIU JinJIN Ying
Department of Clinical Laboratory,Affiliated Hospital of Logistics College of PAP,Tianjin 300162,China
关键词:
中性粒细胞/淋巴细胞比值 血流感染 血培养污染
分类号:
R515; R446.111
DOI:
10.3969/j.issn.1671-7414.2017.02.028
文献标志码:
A
摘要:
目的 探讨中性粒细胞/淋巴细胞比值(NLR)在区分不同病原菌引起的血流感染及鉴别诊断凝固酶阴性葡萄球菌(CNS)血培养污染中的临床应用价值。方法 选取500例同时送检血培养和血常规检查患者资料进行回顾性分析,血培养结果阴性356例,血培养结果阳性144例,根据血培养结果将血培养阳性组分为革兰氏阴性细菌组、革兰氏阳性细菌组、真菌组、CNS污染组以及混合菌感染组。收集血培养结果和计算NLR,采用t检验比较各组细菌NLR水平,采用受试者工作特征曲线(ROC)评价NLR区分不同病原菌引起的血流感染和血培养污染的可能。结果 ①NLR在血培养阴性组、血培养阳性组、CNS血流感染组和血培养污染组分别为6.12,13.15,10.11和6.24。血培养阴性与阳性组和CNS血流感染组与血培养污染组之间经统计学分析差异有统计学意义(P均<0.05)。②NLR在革兰氏阴性菌组、革兰氏阳性菌组以及真菌组分别为15.33,11.63和10.58。革兰氏阴性菌组与革兰氏阳性菌组分别与真菌组对比差异无统计学意义(P>0.05),而在区分革兰氏阴性菌组与革兰氏阳性菌组时,差异有统计学意义(P<0.05)。③NLR区分血培养阴性与阳性、革兰氏阴性菌与革兰氏阳性菌、CNS血流感染与血培养污染的曲线下面积分别为0.86,0.60,0.75; 最佳截断值分别为10.45,7.50,8.10。结论 NLR对预判血流感染及鉴别诊断CNS引起的血流感染具有较好的应用价值。
Abstract:
Objective To investigate the clinical value ofneutrophil-to-lymphocyte ratio(NLR)in identifying blood stream infection caused by different pathogens and for differentiating coagulase negative staphylococcus(CNS)bloodstream infection and contamination.Methods Medical records of 500 patients who underwent blood culture test and routine blood test at the same time were retrospectively analyzed,blood culture negative group 356 patients,blood culture positive group 144 patients,which included Gram-negative group,Gram-positive group,fungi group,CNS bloodstream contamination and mingled group.Collected the results and calculated the NLR at the sametime.NLR were applied by t test of each group.ROC curve was used to determine the cut-off value of NLR.Results ①Mean values of NLR in negative blood culture,blood stream infection group,CNS bloodstream infection and contamination were 6.12,13.15,10.11 and 6.24.NLR had statistical difference between negative blood culture and blood stream infection group,CNS bloodstream infection group and contamination group(P<0.05).②Mean values of NLR in and fungi group were 15.33,11.63 and 10.58,respectively.NLR had statistical difference between Gram-positive bacteria group and Gram-negative bacteria group(P<0.05).NLR had no differences among Gram-positive bacteria(15.33)and Gram-negative bacteria(11.63)compared with(10.58)fungirespectively(P>0.05).③The area under the curve of NLR predicting a positive blood culture,distinguishing Gram-positive bacteria and Gram-negative bacteria,differentiating CNS bloodstream infection and contamination were 0.86,0.60 and 0.75,respectively.The optimal cut-off values of NLR for predictinga positive blood culture,distinguishing Gram-positive bacteria and Gram-negative bacteria,differentiating CNS bloodstream infection and contamination were10.45,7.50 and 8.10 respectively.Conclusion NLR is highly effective in distinguishing blood stream infection and differentiating CNSbloodstream infection and contamination.

参考文献/References:

[1] 翟华丽,刘艳丽,丁丽丽,等.2012~2014年医院血培养主要病原菌分布及耐药性分析[J].现代检验医学杂志,2015,30(3):104-106,110. Zhai HL,Liu YL,Ding LL,et al.Distribution and drug resistance ofmain pathogens isolated from blood culture from 2012 to 2014[J].Journal of Modern Laboratory Medicine,2015,30(3):104-106,110.
[2] Kristóf K1,Kocsis E,Szabó D,et al.Significance of methicillin-teicoplanin resistant Staphylococcus haemolyticus in bloodstream infections in patients of the Semmelweis University Hospitals in Hungary[J].Eur J Clin Microbiol Infect Dis,2011,30(5):691-699.
[3] 刘慧琳,刘桂花,田兆兴.脓毒症患者血中淋巴细胞水平的变化[J].中华危重病急救医学,2014,26(3):148-152. Liu HL,Liu GH,Tian ZX.Changes in blood lymphocytes in sepsis patients[J].Chinese Critical Care Medicine,2014,26(3):148-152.
[4] Karlsson S,Heikkinen M,Pettil V,et al.Predictive value of procalcitonin decrease in patients with severe sepsis:a prospective observational study[J].Crit Care(London,England),2010,14(6):R205.
[5] 中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320. Ministry of Health,People's Republic of China.Clinial criteria ofnosocomial infection(trial implementation)[J].National Medical Journal of China,2001,81(5):314-320.
[6] Suzuki M,Satoh N,Nakamura M,et al.Bacteremia in hemodialysis patients[J].World J Nephrol,2016,5(6):489-496.
[7] 侯伟伟,肖倩茹,江 涟,等.血清降钙素原作为菌血症预示因子临床价值的研究[J].检验医学,2014,29(8):802-805. Hou WW,Xiao QR,Jiang L,et al.Research on the clinical significance of serum procalcitonin in predicting bacteremia[J].Laboratory Medcine,2014,29(8):802-805.
[8] 曹慧玲,李 岷,魏源华,等.血培养病原菌分布及污染菌判定的实验室检查[J].国际检验医学杂志,2011,32(18):2067-2068,2071. Cao HL,Li M,Wei YH,et al.Distribution of pathogens and laboratory examination for identification of contaminants in blood culture[J].International Journal of Laboratory Medicine,2011,32(18):2067-2068,2071.
[9] Yardimci S,Ugurlu MU,Coskun M,et al.Neutrophil-lymphocyte ratio andmean platelet volume can be a predictor for severity of acute appendicitis[J].Ulus Travma Acil Cerrahi Derg,2016,22(2):163-168.
[10] 陈小林,姚国强,刘剑荣.术前外周血中NLR,d-NLR,PLR和LMR四种比值在结直肠癌患者预后诊断中的价值[J].中国免疫学杂志,2015,31(10):1389-1393. Chen XL,Yao GQ,Liu JR.Prognostic value of pre-operative NLR,d-NLR,PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients[J].Chinese Journal of Immunology,2015,31(10):1389-1393.
[11] 金露萍,黄淑田,尹慧娟,等.中性粒细胞/淋巴细胞与急性冠状动脉综合征及其预后的关系[J].中华临床医师杂志(电子版),2012,6(13):55-58. Jin LP,Huang ST,Yin HJ,et al.The association of the neutrophil/lymphocyte ratio and patients suspected of acute coronary syndrome and its prognosis[J].Chinese Journal of Clinicians(Electronic Edition),2012,6(13):55-58.
[12] 胡道军,郁 淼,张洪磊,等.基于Logistic回归和ROC曲线综合评价IMA,NLR,hs-CRP和CK-MB联合检测对早期急性心肌梗死的诊断价值[J].现代检验医学杂志,2016,31(5):76-80. Hu DJ,Yu M,Zhang HL,et al.Comprehensive evaluation of the diagnostic value of the combined detection of IMA,NLR,hs-CRP and CK-MB for acute myocardial infarction based on ROC curve and logistic regression analysis[J].Journalof Modern Laboratory Medicine,2016,31(5):76-80.
[13] 杨 萌,李丽娟,苏 楠,等.动态监测外周血中性粒细胞/淋巴细胞比值能够预测血流感染患者的预后[J].中华危重病急救医学,2015,27(6):471-476. Yang M,Li LJ,Su N,et al.Dynamic monitoring of the neutrophil/lymphocyte ratio could predict the prognosis of patients with bloodstream infection[J].Chinese Critical Care Medicine,2015,27(6):471-476.

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备注/Memo

备注/Memo:

作者简介:任党利(1985-),女,硕士,检验技师,主要从事临床检验诊断学工作和研究,Tel:022-60577195,15022625256,E-mail:ren.dangli@163.com。
通讯作者:靳 颖,副主任技师,主要从事临床微生物学检验,E-mail:jinying9032@hotmail.com。
更新日期/Last Update: 2017-04-10