网织血小板检测在急性白血病继发感染患者中的临床意义

摘要

Objective To explore the clinical significance of the detection of reticulocyte percentage platelets in acute leukemia patients with infectious diseases.Methods The indicators including peripheral white blood cell count(WBC), neutrophil percentage(N%), platelet count(PLT), C-reactive protein(CRP), pro calcitonin(PCT) and reticulocyte percentage platelets(RP%), axillary temperature(T) of 189 cases of acute leukemia patients with suspected infection were respectively detected and recorded,and their diagnostic value was compared by ROC curve.The relationship between the RP% and the mortality associated with severe infection analyzed by Kaplan Meier survival curve.Results The area under the ROC curve for RP% in diagnosis of infection and severe infection were significantly higher than those traditional inflammation indexes.Kaplan Meier survival curve showed that mortality risk was significantly different when patients were stratified based on RP%(P<0.05).Conclusion The diagnostic value of RP% is highest in diagnosis of infection and severe infection compared with traditional inflammation index,and the early diagnostic rate can be well improved combind with CRP and(or) PCT.Furthermore the RP% can be used as an indicator to predict the risk of death.%目的 探讨网织血小板检测在急性白血病(AL)患者继发感染时的诊断价值.方法 选取189例疑似感染的AL患者,分别测定并记录其外周血白细胞计数(WBC)、中性粒细胞(N)百分比、血小板计数(PLT)、C反应蛋白(CRP)、降钙素原(PCT)、网织血小板(RP)百分比、腋下温度(T).应用受试者工作曲线(ROC)进行诊断价值比较.采用Kaplan-Meier生存曲线分析RP百分比与重症感染相关的死亡率之间的关系.结果 RP百分比在诊断AL继发感染及重症感染时ROC曲线下面积明显高于其他传统炎症指标;RP百分比与CRP或PCT联合诊断感染时其灵敏度和特异度显著提高;RP百分比<9.76%的重症感染组患者40 d累计生存率明显高于RP百分比≥9.76%的重症感染组患者(P<0.05).结论 相较于传统炎症指标,RP百分比在诊断AL患者继发感染及重症感染时诊断价值最高,与CRP和(或)PCT联合检测有助于提高AL患者继发感染的早期诊断率.RP百分比可作为预测死亡风险的一项指标.