基于血常规及相关指数对NCP早期鉴别诊断的初步探讨

The Value of Blood Routine and Related Indexes for Early Differential Diagnosis in Novel Coronavirus Pneumonia: A Preliminary Study

摘要: 目的：探讨血常规及相关指数在新型冠状病毒肺炎(NCP)早期鉴别诊断中的价值。方法：回顾性分析2020年1月23日至2020年2月10日兰州大学第二医院确诊的5例NCP患者、11例疑似病例及同期住院的12例其他肺炎患者的血常规、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)和淋巴细胞/单核细胞比值(LMR)的差异，运用受试者工作特征(ROC)曲线的曲线下面积(AUC)评价其对NCP早期鉴别诊断的价值。结果：与疑似病例和其他肺炎患者相比，NCP患者早期WBC、BA#和PLT均降低，存在显著性差异(P < 0.05)。ROC分析显示，WBC对应AUC为0.95 (95% CI = 0.87~1.03)，BA#对应AUC为0.86 (95% CI = 0.70~1.01)，PLT对应AUC为0.85 (95% CI = 0.64~1.07)。结论：基于有限的临床病例，血常规中WBC、BA#和PLT下降均对NCP患者的早期鉴别诊断具有参考价值，但此结论仍需大样本研究进一步证实。

Abstract: Objective: To explore the value of blood routine and related indexes in the early differential diag-nosis of new coronavirus pneumonia (NCP). Methods: A retrospective analysis of hospitalized pa-tients diagnosed as NCP (n = 5), suspected (n = 11 ) and other pneumonia (n = 12) during January 23, 2020 to February 10, 2020 were conducted. The data in blood routine test at initial visit as well as calculated neutrophil/ lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR), and lympho-cyte/monocyte ratio (LMR) were collected and compared. And the receiver operating characteristic (ROC) curve was used to evaluate the area under the curve (AUC) for early differential diagnosis of NCP. Results: Compared with suspected cases and other pneumonia patients, early NCP patients were associated with significantly reduced counts of WBC, BA# and PLT (P <0.05). ROC analysis showed that the AUC of WBC was 0.95 (95%CI, 0.87 to 1.03), AUC of BA# was 0.86 (95%CI, 0.70 to 1.01), and AUC of PLT was 0.85 (95%CI, 0.64 to 1.07). Conclusions: Based on limited number of cases, all of the reduction of WBC, BA# and PLT in blood routine is valuable for the early differential diagnosis of NCP patients, while the finding needs to be further confirmed by large sample studies.