Аннотация
Автоматизированный клинический анализ крови не только характеризуется высокой аналитической точностью, но и предоставляет клиницисту дополнительную и часто ценную информацию в виде новых параметров. Поэтому автоматизация гематологического исследования сделала актуальной проблему интерпретации этих новых показателей. Данная статья – описательный обзор, основанный на анализе 7 обзоров и 45 оригинальных статей. В ней рассматривается диагностическая ценность новых параметров клинического анализа крови, характеризующего нейтрофильные гранулоциты – IG (незрелые гранулоциты), дельта индекс нейтрофилов (delta neutrophil index — DNI). Neut-RI (индекс реактивности), Neut-GI (индекс гранулярности), MNV (средний объем нейтрофилов). Показаны расширившиеся возможности лабораторной диагностики сепсиса и других воспалительных заболеваний, болезней крови ( миелодиспластические синдромы, гемобластозы). В частности, незрелые гранулоциты показали себя как потенциальный инновационный биомаркер тяжести COVID-19, хотя в кохрейневском обзоре, посвященному этой проблеме, в качестве информативных признаков приводятся лишь общее число лейкоцитов и нейтрофилов. Отмечая высокую диагностическую информативость «расширенных» гранулоцитарных параметров необходимо подчеркнуть, что для подтверждения их клинической ценности в диагностике сепсиса и других заболеваний необходимы более масштабные исследования.
Таким образом, современный автоматизированный анализ крови содержит большое количество новых параметров нейтрофилов, которые бесспорно могут использоваться в качестве дополнительных критериев диагностики сепсиса и ряда других заболеваний. Они дают информацию не только о количестве клеток, но и их морфофункциональных особенностях. Пока большинство этих параметров носит статус исследовательских, но тем интереснее могут быть полученные в будущем результаты.
Annotation
Automated cell blood count is characterized by high analytical accuracy and provides the clinician with additional and often valuable information in the form of new parameters. Therefore, automation of hematological examination has made the problem of interpretation of new parameters. This article is a descriptive review based on the analysis of 7 reviews and 45 original articles. It examines the diagnostic value of new parameters of clinical blood analysis characterizing neutrophil granulocytes – IG (immature granulocytes), DNI — delta neutrophil index, Neut-RI (reactivity index), Neut-GI (granularity index), MNV (average volume of neutrophils). The expanded possibilities of laboratory diagnostics of sepsis, surgical and other diseases, blood diseases (myelodysplastic syndromes, hemoblastoses) are shown. For example, immature granulocytes have shown themselves to be a potential innovative biomarker of the severity of COVID-19, although in the Cochrane review devoted to this problem, only the total number of leukocytes and neutrophils is given as informative signs. Noting the high diagnostic informativeness of the «expanded» granulocyte parameters, it should be emphasized that more extensive studies are needed to confirm their clinical value in the diagnosis of sepsis and other diseases.
Thus, modern automated cell blood count contains a new parameters of neutrophils, which can undoubtedly be used as additional criteria for the diagnosis of sepsis and a number of other diseases. They provide information not only about the number of cells, but also their morphofunctional features. So far, most of these parameters have the status of research, but the more interesting the results obtained in the future may be.
Key words: automated cell blood count, neutrophil granulocytes, review.
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