【摘要】 目的回顾性分析初治活动性肺结核(APTB)患者外周血单核细胞群落VCS参数的变化,探讨其诊断APTB的临床应用价值。方法选取2015年10月至2016年1月南通市第六人民医院确诊的APTB患者83例为APTB组和2015年9月至12月于南通市第一人民医院体检的健康者79例为对照组,应用美国Coulter LH 750血液分析仪检测APTB组和对照组的外周血血常规指标,记录单核细胞的各项VCS参数;同时测定并比较两组患者血清白细胞介素-1β(IL-1β)、IL-6及肿瘤坏死因子(TNF-α)表达水平,并对VCS参数和细胞因子浓度进行相关性分析。结果 APTB组患者外周血单核细胞平均体积(MMV)及平均体积分布宽度(MDW)较对照组显著升高,差异具有统计学意义(t=7.616、P <0.001,t=7.349、P <0.001);MMV与IL-1β表达水平呈正相关(r=0.417、P <0.001);MMV的ROC曲线下面积为0.899,且当其临界值取172.6 fl时,诊断APTB的敏感性和特异性分别为80.7%和86.1%。结论 APTB患者外周血单核细胞群落VCS参数发生改变,MMV显著增大并产生异质性,对临床辅助诊断APTB有一定价值。更多还原

【Abstract】 Objective To investigae the changes of VCS parameters of peripheral blood monocyte community in patients with newly diagnosed active pulmonary tuberculosis(APTB), retrospectively, and to explore the clinical value of APTB diagnosis. Methods Total of 83 patients with APTB diagnosed by The Sixth People’s Hospital of Nantong from October 2015 to January 2016 were selected as APTB group and 79 healthy persons examined in The First People’s Hospital of Nantong City from September to December 2015 were selected as control group. The peripheral blood routine indexes of APTB group and control group were detected by Coulter LH 750 blood analyzer, and the monocytes were recorded. The expression levels of interleukin-1β(IL-1β), IL-6 and tumor necrosis factor-α(TNF-α) were measured and compared between the two groups, and the correlation between VCS parameters and cytokine concentration was analyzed. Results The mean volume(MMV) and mean volume distribution width(MDW) of peripheral blood monocytes in APTB group were significantly higher than those of the control group(t = 7.616, P < 0.001; t = 7.349, P < 0.001). There was a positive correlation between MMV and IL-1 β expression(r = 0.417, P < 0.001). The area under the ROC curve of MMV was 0.899, and when the critical value was 172.6 fl, the sensitivity and specificity of diagnosing APTB were 80.7% and 86.1%, respectively. Conclusions The VCS parameters of peripheral blood monocyte community in patients with APTB have been changed, MMV has been increased significantly, and some heterogeneity has been produced, which has certain diagnostic value for clinical auxiliary diagnosis of APTB.更多还原