实用医学杂志 ›› 2022, Vol. 38 ›› Issue (16): 2081-2085.doi: 10.3969/j.issn.1006⁃5725.2022.16.019

• 医学检查与临床诊断 • 上一篇    下一篇

肺泡灌洗液中性粒细胞比例联合革兰染色对肺炎的诊断效能研究

盛梦秋1 张玉3 张淇玮2 张鑫强2 侯铁英1,3    

  1. 1 广东省人民医学院(广东省医学科学院),广东省心血管病研究所,广东省临床检验中心(广州 510120); 广东省人民医院(广东省医学科学院)2 检验科,3 医务处(广州 510120)

  • 出版日期:2022-08-25 发布日期:2022-08-25
  • 通讯作者: 侯铁英 E⁃mail:houtieying@gdph.org.cn
  • 基金资助:
    广东省自然科学基金(编号:2020A1515010136)


Study on the diagnosis efficacy of neutrophil ratio in bronchoalveolar lavage fluid combined with gram stain for pneumonia

SHENG Mengqiu*,ZHANG Yu,ZHANG Qiwei,Zhang Xinqiang,Hou Tieying.   

  1. Guang⁃ dong Clinical Laboratory Center,Guangdong Cardiovascular Institute,Guangdong Provincial People′ s Hospital (Guangdong Academy of Medical Sciences,Guangzhou 510120,China Corresponding author:HOU Tieying E⁃mail:houtieying@gdph.org.cn

  • Online:2022-08-25 Published:2022-08-25
  • Supported by:


摘要:

目的 探讨肺泡灌洗液中性粒细胞比例联合革兰染色对肺炎的诊断效能。方法 回顾性 纳入2018年9月至2021年5月广东省人民医院呼吸内科肺泡灌洗液送检的住院患者188例,其中肺炎患者 为病例组,非肺炎患者为对照组。收集患者人口学资料、临床诊断及肺泡灌洗液中性粒细胞比例、革兰染色结果等临床信息,比较两组患者间差异,并绘制受试者工作特征曲线(receiver operating characteristic, ROC)评价支气管肺泡灌洗液(broncho alveolar lavage fluid,BALF)中性粒细胞比例和革兰染色在肺炎患者 中的诊断价值。结果 病例组 108 例,对照组 80 例,其中病例组社区获得性肺炎 74 例,医院获得性肺炎 34 例。肺炎患者的肺泡灌洗液中性粒细胞比例明显高于非肺炎患者(< 0.01),肺泡灌洗液中性粒细胞 比例诊断肺炎的 Cut⁃off 值为 41.45,灵敏度 0.750,特异度 0.675,ROC 曲线下面积 0.728;在社区获得性肺炎 (community⁃acquired pneumonia,CAP)和医院获得性肺炎医院获得性肺炎(hospital⁃acquired pneumonia, HAP)中,BALF 中性粒细胞比例差异无统计学意义(> 0.05)。BALF 中性粒细胞比例联合镜下革兰染色 诊断肺炎的 Cut⁃off 值为 22.09,灵敏度 0.724,特异度 0.703,ROC 曲线下面积为 0.731。BALF 中性粒细胞比 例联合镜下革兰染色对肺炎诊断效能高于单一 BALF 中性粒细胞诊断效能。BALF 中性粒细胞比例越高 对肺炎的灵敏度越高。结论 BALF 中性粒细胞比例联合镜下革兰染色对肺炎有一定的诊断价值。

关键词:

肺炎, 肺泡灌洗液, 中性粒细胞, 诊断效能

Abstract:

Objective To explore the diagnosis efficacy of neutrophils ratio in bronchoalveolar lavage fluid combined with gram stainingforand pneumonia. Methods A total of 188 patients who received alveolar lavage fluid examination in the Department of Respiratory Medicine of Guangdong Provincial People′s Hospital from September 2018 to May 2021 were retrospectively enrolled,including pneumonia patients as the case group and non⁃pneumonia patients as the control group. Demographic data,clinical diagnosis,neutrophils ratio in bronchoalveolar lavage fluid (BALF),gram stain results and other clinical information of patients were collected,the differences between the two groups were compared,and Receiver Operating Characteristic curves (Receiver Operating Characteristic ROC)to evaluate the neutrophils ratio in BALF and the diagnostic value of Gram stain in patients with pneumonia. Results There were 108 cases in pneumonia group and 80 controls in non⁃pneumonia group. In cases group patients with Community ⁃ acquired pneumonia were 74,patients withHospital ⁃ acquired pneumonia were 34. The bronchoalveolar lavage fluid neutrophil ratios of patients with pneumonia were significantly higher than those of patients without pneumonia(P < 0.01). On the diagnosis of pneumonia,the value of cut⁃off,sensitivity,specificity and the area under ROC curve of neutrophil ratio in bronchoalveolar lavage fluid(BALF)for diagnosis of pneumonia were respectively 41.45,0.750,0.675 and 0.728. The Cut ⁃off of neutrophil ratio in BALF combined microscopic gram staining for the diagnosis of pneumonia was 22.09%,with a sensitivity of 0.724,specificity of 0.703,and an area under ROC curve was 0.731. The diagnosis effect of neutrophil ratio in BALF combined gram stain was higherthan only neutrophil ratio in BALF. The more higher neutrophils ratio in BALF,the higher sensitivity in patientswith pneumonia. Conclusion BALF neutrophils ratio combined with gram stain is significantly on the diagnosis ofpneumonia.

Key words:

text-indent:0pt, "> pneumonia, alveolar lavage fluid, neutrophils, diagnostic