摘要
目的 探讨外周血有核红细胞（NRBC）增高病例的特点及其与疾病转归的关系,为协助临床及早发现患者不良预后提供数据支持.方法 选择2016年1—6月在广州医科大学附属第二医院住院期间外周血NRBC〉0的患者进行回顾性研究,患者分为存活组和死亡组.收集患者的基本信息（性别、年龄）、预后结果（存活或死亡）、住院期间外周血NRBC绝对值（NRBC# ）和外周血NRBC比率（NRBC% ）的最高值、临床诊断进行组间比较分析,采用logistic回归分析患者死亡的独立危险因素,采用受试者工作特征曲线（ROC）评价NRBC#、NRBC% 对患者预后的预测效能.结果 229例外周血NRBC增高患者中死亡48例,存活181例.死亡组的年龄、NRBC#、NRBC% 明显高于存活组（P〈0.05）.年龄、NRBC#、NRBC% 为死亡的独立危险因素,随着外周血NRBC数量增多,患者病死率增大.NRBC#、NRBC% 对患者预后的预测具有统计学意义,其ROC曲线下面积（AUC）分别为0.792和0.713（P〈0.001）.NRBC#和NRBC% 对患者预后的最佳诊断界值分别为0.0550×109/L（灵敏度和特异度分别为81.3% 和69.6% ）和0.950/100白细胞（WBC）（灵敏度和特异度分别为64.6% 和76.2% ）,NRBC# ≥0.0550×109/L或NR-BC% ≥0.950/100WBC可作为判断患者不良预后的＂警戒线＂.结论 随着外周血NRBC数量的增高,患者的死亡风险增大、预后较差,对临床及早发现不良预后具有参考价值;NRBC水平可能成为外周血NRBC升高患者评估临床疗效的指标.
Objective To find the characteristics of the medical records with increased nucleated red blood cell （NRBC）in pe-ripheral blood and its relationship with disease outcome,which is aimed at assisting clinic to find adverse outcomes of patients with early detection.Methods A retrospective study was conducted,which chose inpatients in The Second Affiliated Hospital of Guang-zhou medical university between January 2016 and June 2016,whose nucleated red blood cell increased in peripheral blood as study object.Patients were divided into survival group and death group.By means of collecting,the basic information of the patients,dis-ease outcome,maximum value of NRBC′s absolute value and NRBC′s ratio,clinical diagnosis were collected for the comparison a-mong groups.Logistic regression was used to identify independent risk factors for death.The receiver operating characteristic （ROC）curve was used to evaluate the efficiency of forecasting patients′prognosis with NRBC# and NRBC%.Results In 229 pa-tients with increased NRBC in peripheral blood,48 cases died,181 cases survived.Age,NRBC# and NRBC% in the death group were significantly higher than those in the survival group （P〈0.05）.Age,NRBC#,and NRBC% were independent risk factors for death.With the number of NRBC increasing,the risk of death of patients increases.NRBC# and NRBC% had statistical signifi-cance in predicting the prognosis of patients with AUC of 0.792 and 0.713,respectively （P〈0.001）.The best diagnostic values of NRBC# and NRBC% for predicting patients′prognosis were 0.0550×109/L （sensitivity 81.3% and specificity 69.6% ）and 0. 950/100 white blood cell （WBC）（sensitivity 64.6% and specificity 76.2% ）,respectively.NRBC#≧0.0550×109/L or NRBC%≧0.950/100WBC can be used to be the critical value of poor prognosis.Conclusion With the number of NRBC increasing,the risk of death of patients increases and the patients have a worse prognosis,which has guiding significance for early detection of poor prognosis.
出处
《检验医学与临床》
CAS
2017年第A02期1-4,共4页
Laboratory Medicine and Clinic
基金
国家自然科学基金青年基金（81401686）.
关键词
有核红细胞
预后
判断指标
nucleated red blood
prognosis
critical value
