Chest：单核细胞分布宽度可以改善急诊脓毒症的早期检测！

2017-06-23 xing.T MedSci原创

由此可见，在急诊入院时将MDW与WBC合并比单独的白细胞可以提高脓毒症的检测能力。

脓毒症在急诊科可以经常见到，延迟检测是有害的。白细胞计数常被用来检测脓毒症，但白细胞大小的变化也与脓毒症相一致。近日，呼吸领域权威杂志chest上发表了一篇研究文章，研究人员试图确定循环中免疫细胞体积的增大是否增加了白细胞在早期脓毒症检测中的价值。

研究人员对一所大型教学医院的两个不同急诊人群进行双盲的、前瞻性队列研究。

研究人员采用全自动分析仪在入院常规CBC检测时结合检测了中性粒细胞和单核细胞的体积参数，并用于脓毒症的检测。该研究连续入选了1320名急诊患者，分为对照组（n＝879）、全身炎症反应综合征（SIRS）组（n＝203）、感染组（n＝140）或败血症组（n＝98）。

研究人员发现与其他参数相比，单核细胞分布宽度（MDW）是鉴别脓毒症与所有其他疾病 [AUC为0.79（95%可信区间：0.73-0.84）]；灵敏度为0.77，特异性为0.73；MDW 阈值为20.50]、将脓毒症从SIRS中区分出来[AUC为0.74（95%可信区间：0.67-0.84）]以及将严重脓毒症从非感染急诊患者中区分出来[AUC为0.88（95%可信区间：0.75-0.99）；NPV为99%] 的最佳指标。将MDW的值加入动到WBC具有统计学意义（MDW+WBC的AUC为0.89 vs. WBC单独为0.81；P＜0.01）；并且决定曲线分析也表现出相比于单独的WBC性能有所改进。

由此可见，在急诊入院时将MDW与WBC合并比单独的白细胞可以提高脓毒症的检测能力。

原始出处：

Elliott D. Crouser,et al. Improved Early Detection of Sepsis in the Emergency Department with a Novel Monocyte Distribution Width Biomarker.chest.2017. http://journal.publications.chestnet.org/article.aspx?articleid=2634641

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2017-08-20 xiangyuzhou971

#EST#

76 0
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2018-02-07 Smile2680

#Chest#

0 0
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2017-07-06 虈亣靌

学习谢谢分享

102 0
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2017-06-24 雕雕

#单核细胞#

72 0
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2017-06-24 meiliwuxian

学习一下

102 0
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2017-06-24 jyzxjiangqin

急诊脓毒症的早期检测。

110 0
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2017-06-23 虈亣靌

这个可以啊，不错

119 0
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2017-06-23 执着追梦

谢谢，谢谢分享

96 0
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2017-06-23 雾夜芭蕾

单核细胞宽度可以改善急性脓毒血症早期检测

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