纪国文 卫雨清 刘宏炜 潘天宇 段晶晶

*基金项目：上海市奉贤区科委项目（奉科20201616）

【摘要】 目的：探讨外周血白细胞分类计数及其比例在甲型流感病毒感染患者中的应用价值。方法：回顾性收集上海市奉贤区奉浦街道社区卫生服务中心发热门诊2023年3—4月收治的具有呼吸道及相关全身症状的患者153例，按甲型流感病毒快速抗原检测结果分为甲型流感组71例和非甲型流感组82例。记录患者性别、年龄、最高体温、白细胞计数（WBC）、中性粒细胞计数（NC）、淋巴细胞计数（LC）、单核细胞计数（MC）、嗜酸性粒细胞计数（EOS）及中性粒细胞百分比（NE％），淋巴细胞百分比（LY％），单核细胞百分比（MO%），嗜酸性粒细胞百分比（EOS%）。采用受试者操作特征（ROC）曲线评价白细胞分类计数及其比例对甲型流感病毒感染的诊断效能。结果：甲型流感组WBC、NC、LC、EOS及EOS%均低于非甲型流感组（P<0.05），最高体温和MO%均高于非甲型流感组（P<0.05）。ROC曲线分析结果显示，MO%诊断甲型流感病毒感染的曲线下面积为0.704，最佳临界点为9.35%，敏感度和特异度分别为77.5%和65.9%。结论：甲型流感病毒感染患者外周血WBC、NC、LC、EOS及EOS%降低，MO%升高对甲型流感病毒感染有较好的辅助诊断价值。

【关键词】 甲型流感病毒 白细胞计数 单核细胞计数比例

Clinical Significance of Peripheral Blood Leukocyte Classification Counts and Their Proportions in Patients with Influenza A Virus Infection/JI Guowen， WEI Yuqing， LIU Hongwei， PAN Tianyu， DUAN Jingjing. //Medical Innovation of China， 2024， 21（15）： 0-093

[Abstract] Objective： To explore the application value of peripheral blood leukocyte classification counts and their proportions in patients with influenza A virus infection. Method： A total of 153 patients with respiratory and related systemic symptoms who were admitted to the Fever Clinic of Fengpu Street Community Health Service Center， Fengxian District， Shanghai from March to April 2023 were retrospective collected， according to the results of rapid antigen test of influenza A virus， they were divided into 71 cases of influenza A group and 82 cases of non influenza A group. The patient's sex， age， maximum body temperature， white blood cell count （WBC）， neutrophil count （NC）， lymphocyte count （LC）， monocyte count （MC）， eosinophil count （EOS） and neutrophil percentage （NE%）， lymphocyte percentage （LY%）， monocyte percentage （MO%）， eosinophil percentage （EOS%） were recorded. The diagnostic efficacy of leukocyte classification counts and its proportion for influenza A virus infection was evaluated by the receiver operating characteristics （ROC） curve. Result： WBC， NC， LC， EOS and EOS% in the influenza A group were lower than those in the non influenza A group （P<0.05）; and the highest body temperature and MO% were higher than those in the non influenza A group （P<0.05）. The ROC analysis results showed that the area under the curve for MO% to diagnose influenza A virus infection was 0.704， the optimal critical point was 9.35%， and the sensitivity and specificity were 77.5% and 65.9%， respectively. Conclusion： The peripheral blood WBC， NC， LC， EOS and EOS% of patients infected with influenza A virus decrease， while the MO% increase， which has good auxiliary diagnostic value for influenza A virus infection.

[Key words] Influenza A virus White blood cell count Monocyte count proportion

First-author's address： Department of Respiration， Shanghai Fengxian Central Hospital， Shanghai 201499， China

doi：10.3969/j.issn.1674-4985.2024.15.021

流行性感冒（influenza，简称流感）是一种由流感病毒引起、具有高度传染性和较高发病率的急性呼吸道疾病，对人类健康构成了巨大威胁[1]。我国每年大约有8.8万人死于流感相关的呼吸系统疾病，占呼吸系统疾病死亡数的8.2%[2]。婴幼儿、老年人、孕产妇和慢性疾病患者是流感高发人群，且患流感后出现严重疾病或死亡的风险较高[3]。流感病毒根据病毒内核蛋白和基质蛋白抗原性的不同，分为甲、乙、丙、丁（或A、B、C、D）4型，其中甲型流感病毒易引起季节性流行，曾多次引起世界性的大流行，对人类生命健康威胁严重，应做到尽快诊断、尽早抗病毒治疗方能减少其并发症、降低病死率。……