Eosinophil count (EC) as a diagnostic and prognostic marker for infection in the internal medicine department setting
Eosinophil count (EC) as a diagnostic and prognostic marker for infection in the internal medicine department setting
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DOI：
10.2478/rjim-2018-0039
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发表时间：
2019-06-01
影响因子：
1.9
通讯作者：
Lydakis, Charalampos
中科院分区：
文献类型：
--
作者：
Karakonstantis, Stamatis;Gryllou, Niki;Lydakis, Charalampos
介绍。以前研究过嗜酸性粒细胞减少作为区分感染性和非感染性诊断的标志，并作为预后标志。大多数先前的研究是在重症监护病房患者中进行的。我们的研究重点是探讨在内科住院的患者中红细胞减少的价值。我们回顾性分析了271例连续感染患者和31例表现为发热或炎症综合征但诊断为非感染性的患者。我们评估并比较了以下用于区分感染性和非感染性诊断的标志物：嗜酸性粒细胞计数[EC]、CRP、WBC和中性粒细胞与淋巴细胞计数比[NLCR]。我们还评估了红细胞减少作为感染患者监测参数的价值。入院时感染患者中有71%出现红细胞减少，而非感染组为32%。EC和NLCR是区分感染和非感染的中等指标，在受者工作特征曲线下的面积分别为0.789和0.718。感染组明显的红细胞减少（400/ μ L）少见（1.5%），而非感染组不少见（25.8%）。与存活者EC的快速正常化相比，非存活者存在持续的红细胞减少。在表现为发热和/或高炎症标志物的患者中，低EC支持感染，而高EC可能提示非感染性诊断。红细胞减少的持续/消退可能是预测治疗反应的一个有用的监测参数。
Introduction. Eosinopenia has been previously investigated as a marker to differentiate infectious from non-infectious diagnoses and as a prognostic marker. Most previous studies were conducted in intensive care unit patients. Our study focuses on the value of eosinopenia in patients admitted to the Internal Medicine department.Methods. We retrospectively analyzed 271 consecutive patients with infection and 31 patients presenting with fever or inflammatory syndrome and a non-infectious diagnosis. We evaluated and compared the following markers for differentiating infectious from non-infectious diagnoses: eosinophil count [EC], CRP, WBC and neutrophil-to-lymphocyte count ratio [NLCR]. We also evaluated the value of eosinopenia as a monitoring parameter in patients with infections.Results. Eosinopenia at admission was found in 71% of patients with infection compared to 32% in the non-infection group. EC and NLCR were moderate markers for discriminating infection from non-infection, with an area under the receiver operating characteristic curve of 0.789 and 0.718 respectively. Significant eosinopenia ( 400/mu L) was rare in the infection group (1.5%), but not uncommon in the non-infection group (25.8%). Persistent eosinopenia was noted in non-survivors, compared to the rapid normalization of EC in survivors.Conclusions. Among patients presenting with fever and/or high inflammatory markers a low EC is supportive of infection, while a high EC may suggest non-infectious diagnoses. The persistence/resolution of eosinopenia may be a useful monitoring parameter to predict response to therapy.