INT J LAB HEMATO：外周颗粒状淋巴细胞减少症和畸形白细胞增多症作为 COVID-19 的简单预后标志物

2021-09-19 MedSci原创 MedSci原创

基本 PB 检查可用于预测 COVID-19 的预后。变化与疾病的严重程度动态相关，并且可能与严重感染中由于骨髓压力引起的造血和免疫系统的破坏有关。

虽然大多数冠状病毒病 (COVID-19) 患者症状较轻，但多达 15% 的患者会发展为重症肺炎，约 5% 的患者会出现急性呼吸窘迫综合征和/或多器官衰竭。除支持性治疗外没有经过验证的补救措施，但开发预后标志物可用于临床决策，例如插管时间和体外膜氧合的引入。

近期，国外研究团队开展了相关研究，评估调查 PB 检查是否可以预测冠状病毒病 (COVID-19) 的预后。相关结果发表在国际实验室血液学杂志杂志上。

研究对 38例健康对照 (HCs) 和 40例新冠病毒肺炎患者（COVID-19 ）进行全血细胞计数 (CBC) 和 PB 细胞形态学检查。使用Sysmex XN-3000自动血液分析仪和Sysmex DI-60使用基于卷积神经网络的自动图像识别系统进行PB检查。使用 Wilcoxon 秩和检验来评估新冠病毒肺炎患者与健康对照之间以及具有不同疾病严重程度的患者之间的血液检测结果和形态异常差异的显着性。

在COVID-19患者中，重症组表现出显著较高的WBC、中性粒细胞计数、NLR、未成熟粒细胞、RDW-SD和CRP水平。此外，重度组的淋巴细胞计数、活性淋巴细胞、Hb 和 PLT 水平明显低于轻度组（P <.0001）。

COVID-19患者血细胞的形态变化和健康对照

粒状淋巴细胞与COVID-19严重性关联

与轻度病例相比，重度病例的贫血、淋巴细胞减少和白细胞增多的发生率显着升高（P < .001）。在轻度病例中，颗粒淋巴细胞计数正常或更高，而在致命病例中则持续下降。颗粒淋巴细胞的暂时增加与严重感染患者的存活率有关。重症病例的红细胞分布宽度显着高于轻度病例（P < .001）。在 COVID-19 病例中一致观察到中性粒细胞发育不良，但在 HC 中未观察到。在严重的情况下，巨大的中性粒细胞和有毒肉芽/Döhle 小体的水平会增加。

综上，研究表明通过检测 SARS-CoV-2 感染引起的血细胞计数和形态异常的多谱系变化，基本 PB 检查可用于预测 COVID-19 的预后。变化与疾病的严重程度动态相关，并且可能与严重感染中由于骨髓压力引起的造血和免疫系统的破坏有关。

原始出处：

Horiuchi Y, Hayashi F, Iwasaki Y, Matsuzaki A, Nishibe K, Kaniyu K, Marutani S, Saito K, Matsuoka S, Uchihashi K, Miida T, Ai T, Tabe Y. Peripheral granular lymphocytopenia and dysmorphic leukocytosis as simple prognostic markers in COVID-19. Int J Lab Hematol. 2021 Sep 15. doi: 10.1111/ijlh.13696. Epub ahead of print. PMID: 34523805.

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2021-10-03 shock_melon

#白细胞增多症#

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2021-10-31 xuruicheng

#预后标志#

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2021-10-23 hukaixun

#标志物#

81 0
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2021-09-21 wetgdt

#淋巴细胞#

74 0
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2021-09-21 fengyi812

#EMA#

61 0
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2021-09-21 wushaoling

#畸形#

82 0
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2021-09-21 ms7514935887898259

#预后标志物#

79 0
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2021-09-20 查查佳佳

额粗爱么路嗯啦额辛辣刺激

65 0
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2021-09-20 病毒猎手

NLR早已证实了

70 0

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INT J LAB HEMATO：外周颗粒状淋巴细胞减少症和畸形白细胞增多症作为 COVID-19 的简单预后标志物

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