Diagnostic Value Of Blood Smear In Children With Infectious Diseases

Objective To study the diagnostic significance of peripheral blood cell proportion and morphology changes in children with infectious diseases,and to provide some new ideas for clinical differentiation of infectious diseases and exclusion of hematologic diseases.Methods 181 out-patient and in-patient children in our hospital were selected as the study group,and 49 healthy children in our hospital were selected as the control group.First of all,the venous blood samples of children,with EDTA-k2 anticoagulant tube collection of 0.5 ml,by peripheral blood cell examination professionals to push,parallel standard Rui-Jishi staining,and then to the standard procedures for microscopic observation,review by professionals.Secondly,according to the inclusion criteria and exclusion criteria,the patients were divided into two groups,the first group was bacterial infectious disease group;The second group is virus infection group;The third group was mycoplasma infection group;In addition,49 normal patients were selected as the healthy control group,and the other three groups were confirmed as the observation group.The data of this study were processed by SPSS 18.0 statistical software,and the counting data were compared.the data were expressed by rate,x-test and nonparametric test of multiple independent samples.the difference was statistically significant with p <0.05.Results 1.There was no significant difference in age and sex among bacteria infection group,virus infection group,mycoplasma infection group and healthy control group(p > 0.05).2.Compared with the healthy control group,the number of white blood cells in the bacterial infection group was increased,the number of white blood cells in the viral infection group was decreased,and the number of mycoplasma infection group was basically within the normal range.There was statistical difference in leukocyte between different groups(p < 0.05).3.Compared with the healthy control group,the proportion of neutrophils in bacteria infection group and mycoplasma infection group was higher than that in virus infection group,and the proportion of neutrophils in virus infection group was lower.The proportion of neutrophils in different groups was significantly different(p < 0.05).4.Compared with the healthy control group,the proportion of rod-shaped nuclei in bacterial infection group was more than 5 %,mostly in 5 %-10 % and 10 %-25 %,and part was more than 25 %;The proportion of baculovirus infection was basically the same as that of healthy control group,mostly less than 5 %.The proportion of rod-shaped nuclei in mycoplasma infection group was mostly less than 5 %,and the proportion of rod-shaped nuclei in mycoplasma infection group was 5 %-10 %.The percentage of neutrophil rod-like nucleus in different groups was significantly different(p < 0.05).5.Compared with the healthy control group,the proportion of lymphocytes in bacterial infection group was much lower,the proportion of lymphocytes in viral infection group was much higher,and the proportion of lymphocytes in mycoplasma infection group was lower or normal.There was significant difference in lymphocyte ratio between different groups(p < 0.05).6.Compared with healthy control group,monocytes in bacterial infection group were normal.The monocytes in the virus-infected group were partly increased,mostly normal or decreased.Most monocytes in mycoplasma infection group increased.The proportion of monocytes in different groups was significantly different(p < 0.05).7.Most of the atypical lymphocytes in bacteria infection group,mycoplasma infection group and healthy control group were less than 2 %,basically in the normal range.Most of the atypical lymphocytes in virus infection group were 2 %-10 %,but also more than 10 % and less than 2 %.there was statistical difference in the proportion of atypical lymphocytes between different groups(p < 0.05).8.There was almost no vacuolation in cytoplasm of neutrophils in virus infection group,mycoplasma infection group and healthy control group,and vacuolation in cytoplasm of neutrophils in bacteria infection group was not found in most cases.there was significant difference between different groups(p < 0.05).9.Most of the bacterial infection group will have poisoning particles,a small number of no;There were no toxic granules in virus infection group,mycoplasma infection group and healthy control group.there were statistical differences in neutrophil cytoplasmic toxic granules between different groups(p < 0.05).Conclusion The detection of peripheral blood smear can directly reflect the true morphology of cells,not only can observe the change of the proportion of each white blood cell,but also can observe the change of the morphology and structure of each cell.Bacterial infectious disease often causes the increase of leukocyte count and neutrophil number in peripheral blood smear,neutrophil cytoplasm often appear toxic changes(vacuolar degeneration,poisoning particles),serious infection will appear nuclear left shift phenomenon.Virus infection disease white blood cell count is not high,often low,lymphocyte ratio increased,monocyte ratio can be high,can be normal,neutrophil ratio is generally normal,atypical lymphocytes in 2 %-10 % change,when there is ebv infection rate is often more than 10 %.The leukocyte count of mycoplasma infection disease is normal,neutrophil proportion is slightly increased,monocyte mostly slightly increased or increased.During the examination of peripheral blood smears,parasitic infection,fungal infection,endophytic bacterial infection and blood system diseases were excluded by the changes of cell morphology.