Clinical value of blood cell morphological indexes in etiological diagnosis of unexplained fever

Li Jiang; Zhang Jinpeng

doi:10.3969/j.issn.1674-7151.2024.02.004

Abstract：Objective To investigate the clinical value of blood cell morphological indexes in the etiological diagnosis of patients with unexplained fever.Methods The 50 patients with unexplained fever who received treatment in Pingshan District People's Hospital of Shenzhen from April 2021 to August 2023 were selected as research objects and included in observation group,and 50 healthy subjects who underwent physical examination during the same period were selected as control group.Blood routine test and microscopic blood smear staining were performed in both groups and the abnormal blood cell conditions and differences in blood cell morphological indicators were compared.Spearman correlation analysis was used to evaluate the correlation between blood cell morphological indicators and unexplained fever.The receiver operator characteristic(ROC)curve was plotted and area under ROC curve(AUC)was calculated to evaluate the diagnostic value of blood cell morphological indicators in the diagnosis of unexplained fever.Results Comparison of blood cell abnormalities:the abnormal cell rate,large cell anemia rate,small cell anemia rate,atypical lymphocyte change rate and white blood cell change rate in observation group were higher than those in control group(abnormal cell rate:16.00%vs.4.00%;large cell anemia rate:4.12%vs.0%;small cell anemia rate:10.00%vs.0%;atypical lymphocyte change rate:24.00%vs.4.00%;white blood cell change rate:20.00%vs.6.00%;all P<0.05).Comparison of blood cell morphological indicators:the levels of mean corpuscular volume(MCV),hematocrit(Hct)and red cell distribution width standard deviation(RDW-SD)in observation group were significantly higher than those in control group[MCV(fL):89.07±4.24 vs.84.25±5.38;Hct:(46.79±3.20)%vs.(44.68±3.56)%;RDW-SD:(15.29±2.67)%vs.(12.48±2.30)%;all P<0.05].There were no significant differences in mean corpuscular hemoglobin(MCH)and mean corpuscular hemoglobin contentration(MCHC)between observation group and control group[MCH(pg):32.20±1.49 vs.31.62±1.77;MCHC(g/L):344.81±8.15 vs.342.26±6.53;both P>0.05].Spearman correlation analysis showed that MCV,Hct and RDW-SD were positively correlated with unexplained fever(r values were 0.469,0.454,0.434,all P<0.001).ROC curve analysis showed that MCV,Hct and RDV-SD had high diagnostic value for unexplained fever[AUC was 0.806,0.687 and 0.759,95%confidence interval(95%CI)was 0.720-0.893,0.583-0.791 and 0.665-0.853,all P<0.001].Conclusions There are differences in blood cell morphology in patients with unexplained fever.The detection of MCV,Hct and RDW-SD could provide reference for clinical diagnosis and auxiliary treatment guidance.