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用于诊断新生儿败血症的简单血液学检查。

Simple hematological tests for diagnosis of neonatal sepsis.

作者信息

Misra P K, Kumar R, Malik G K, Mehra P, Awasthi S

出版信息

Indian Pediatr. 1989 Feb;26(2):156-60.

PMID:2753532
Abstract

Simple hematological tests, TLC, DLC, mESR, platelet count, were performed in 128 neonates of which 50 were controls and 78 were cases of suspected septicemia. Thirty three had positive blood cultures and were taken as 'proved' and remaining as 'probable' sepsis. A band cell neutrophil (B/N) ratio of greater than 0.2 was most sensitive index (92%) followed by raised mESR of greater than 8 mm for 1st hour, whereas leukopenia of greater than 5 x 10(3)/mm3 was most specific index (88%) for the diagnosis of sepsis. Thrombocytopenia of less than 1.5 x 10(5)/cu mm was also taken as positive test for sepsis. A combination of three positive tests had highest positive predictive accuracy (94%) for early diagnosis of sepsis, when compared to single test or two positive test combinations. The best combination of tests was B/N ratio, leukopenia and mESR which can be easily done in a side laboratory.

摘要

对128例新生儿进行了简单的血液学检查,包括白细胞分类计数(TLC)、白细胞分类(DLC)、平均血沉率(mESR)、血小板计数,其中50例为对照组,78例为疑似败血症病例。33例血培养呈阳性,被视为“确诊”败血症,其余则为“疑似”败血症。杆状核中性粒细胞(B/N)比例大于0.2是最敏感的指标(92%),其次是第1小时平均血沉率升高大于8mm,而白细胞减少大于5×10³/mm³是败血症诊断最具特异性的指标(88%)。血小板减少低于1.5×10⁵/cu mm也被视为败血症的阳性检测结果。与单项检测或两项阳性检测组合相比,三项阳性检测组合对败血症的早期诊断具有最高的阳性预测准确性(94%)。最佳的检测组合是B/N比例、白细胞减少和平均血沉率,这些检测在床边实验室即可轻松完成。

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