Meriyanti Tandry, Aruan Maroloan, Ananda Glorya N D
Medical Laboratory Technology Department, Faculty of Health Science, Pelita Harapan University, Tangerang, Banten, Indonesia.
Laboratory Department, Siloam Hospitals Lippo Village, Tangerang, Banten, Indonesia.
Adv Hematol. 2025 Apr 21;2025:8080147. doi: 10.1155/ah/8080147. eCollection 2025.
Acute febrile illness contributes to significant morbidity and death particularly in tropical country such as Indonesia. The symptoms are nonspecific, therefore distinguishing these pathogens is difficult without additional laboratory tests. The extended white blood cell parameters indicate cell activities induced by immune response to infection. The study aims to explore the profile of extended white blood cell parameters in acute febrile illnesses and evaluate their diagnostic power to differentiate etiologies of acute febrile illnesses. This study was a cross-sectional analytical study with a total of 473 samples, conducted between October 2022 and 2023 at Siloam Hospitals Lippo Village, Banten, Indonesia. Acute febrile illnesses are included in this study, including dengue infection, chikungunya infection, typhoid infection, and other bacterial infections. The extended white blood cell parameters including high fluorescence lymphocyte count (HFLC), immature granulocyte (IG), neutrophil-to-lymphocyte ratio (NLR), and cell population data (CPD) which were NE-SSC, NE-SFL, NE-WY, LY-X, LY-Y, and LY-WY. These parameters were integrated in a routine hematology test as research parameters, performed by Sysmex XN2000. Data were analyzed using SPSS Version 25. The value of extended white blood cell parameters was found to be significantly different in viral and bacterial infection (HFLC 1.10% (0.30%-3.85%) vs. 0.20% (0.10%-0.70%), < 0.001; IG 0.4% (0.2%-0.6%) vs. 0.5% (0.3%-1.1%), < 0.001; NLR 1.93 (1.10-3.47) vs. 5.21 (2.20-12.26), < 0.001; NE-SFL 47.7 (45.95-50.10) vs. 48.6 (45.82-52.57), =0.020; NE-WY 622 (585-653) vs. 653 (615-747), < 0.001; LY-Y 66.4 (63.85-69.75) vs. 64.05 (60.52-67.17), < 0.001). HFLC and LY-Y had statistically significant AUC 0.753 and 0.646, respectively, ( < 0.001) in the dengue infection group. IG, NLR, NE-WY, and NE-SFL had statistically significant AUC in bacteremia (0.806, 0.876, 0.783, and 0.656, respectively). HFLC was a useful diagnostic tool to identify viral infection, particularly dengue infection, while IG, NLR, NE-SFL, and NE-WY can be useful to differentiate bacteremia from other acute febrile illnesses.
急性发热性疾病会导致严重的发病和死亡，尤其是在印度尼西亚这样的热带国家。其症状不具有特异性，因此在没有额外实验室检测的情况下很难区分这些病原体。扩展的白细胞参数表明了免疫反应对感染诱导的细胞活动。本研究旨在探索急性发热性疾病中扩展白细胞参数的概况，并评估其区分急性发热性疾病病因的诊断能力。本研究是一项横断面分析研究，共收集了473个样本，于2022年10月至2023年在印度尼西亚万丹省利宝村的西罗亚姆医院进行。本研究纳入了急性发热性疾病，包括登革热感染、基孔肯雅热感染、伤寒感染和其他细菌感染。扩展的白细胞参数包括高荧光淋巴细胞计数（HFLC）、未成熟粒细胞（IG）、中性粒细胞与淋巴细胞比值（NLR）以及细胞群体数据（CPD），即NE-SSC、NE-SFL、NE-WY、LY-X、LY-Y和LY-WY。这些参数作为研究参数整合到由Sysmex XN2000进行的常规血液学检测中。使用SPSS 25版对数据进行分析。结果发现，病毒感染和细菌感染时扩展白细胞参数的值存在显著差异（HFLC：1.10%（0.30%-3.85%）对0.20%（0.10%-0.70%），<0.001；IG：0.4%（0.2%-0.6%）对0.5%（0.3%-1.1%），<0.001；NLR：1.93（1.10-3.47）对5.21（2.20-12.26），<0.001；NE-SFL：47.7（45.95-50.10）对48.6（45.82-52.57），=0.020；NE-WY：622（585-653）对653（615-747），<0.001；LY-Y：66.4（63.85-69.75）对64.05（60.52-67.17），<0.001）。在登革热感染组中，HFLC和LY-Y的曲线下面积（AUC）分别具有统计学意义，为0.753和0.646（<0.001）。IG、NLR、NE-WY和NE-SFL在菌血症中的AUC具有统计学意义（分别为0.806、0.876、0.783和0.656）。HFLC是识别病毒感染，尤其是登革热感染的有用诊断工具，而IG、NLR、NE-SFL和NE-WY有助于区分菌血症与其他急性发热性疾病。
