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中华实验和临床感染病杂志(电子版)

中华实验和临床感染病杂志(电子版) ›› 2018, Vol. 12 ›› Issue (05) : 478 -482. doi: 10.3877/cma.j.issn.1674-1358.2018.05.011

所属专题： 文献；

论著

单核细胞群落VCS参数诊断活动性肺结核的价值
沈甜1, 施军卫2, 顾德林1, 张海云1, 喻禹3, 朱易华4, 陶国华4, 蔡慧慧1, 曹兴建4,†()   
  1. 1. 226011　南通市，南通市第六人民医院检验科
    2. 226011　南通市，南通市第六人民医院结核科
    3. 226011　南通市，南通市第六人民医院信息科
    4. 226001　南通市，南通大学附属第二医院检验科
  • 收稿日期:2018-02-19 出版日期:2018-10-15
  • 通信作者: 曹兴建
  • 基金资助:
    南通市卫生和计划生育委员会科研项目(No. WKZL2018068)

Value of monocyte VCS parameters for predicting active pulmonary tuberculosis

Tian Shen1, Junwei Shi2, Delin Gu1, Haiyun Zhang1, Yu Yu3, Yihua Zhu4, Guohua Tao4, Huihui Cai1, Xingjian Cao4,†()   

  1. 1. Department of Laboratory, The Sixth People’s Hospital of Nantong, Nantong 226011, China
    2. Department of Tuberculosis, The Sixth People’s Hospital of Nantong, Nantong 226011, China
    3. Department of Information, The Sixth People’s Hospital of Nantong, Nantong 226011, China
    4. Department of Laboratory, The Second Affiliated Hospital of Nantong University, Nantong 226001, China
  • Received:2018-02-19 Published:2018-10-15
  • Corresponding author: Xingjian Cao
  • About author:
    Corresponding author: Cao Xingjian, Email:
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引用本文：

沈甜, 施军卫, 顾德林, 张海云, 喻禹, 朱易华, 陶国华, 蔡慧慧, 曹兴建. 单核细胞群落VCS参数诊断活动性肺结核的价值[J]. 中华实验和临床感染病杂志(电子版), 2018, 12(05): 478-482.

Tian Shen, Junwei Shi, Delin Gu, Haiyun Zhang, Yu Yu, Yihua Zhu, Guohua Tao, Huihui Cai, Xingjian Cao. Value of monocyte VCS parameters for predicting active pulmonary tuberculosis[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2018, 12(05): 478-482.

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。

关键词: VCS参数, 单核细胞, 肺结核, 细胞因子
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 ofinterleukin-1β(IL-1β), IL-6 andtumor 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-1βexpression (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.

Key words: VCS parameter, Monocyte, Active pulmonary tuberculosis, Cytokine
表1 APTB组和健康对照组VCS参数(±s)
组别 例数 MMV(fl) MDW MMC MMS
健康对照组 79 167.63 ± 5.52 18.25 ± 2.18 116.03 ± 5.95 87.68 ± 5.43
APTB组 83 176.69 ± 8.79 20.97 ± 3.07 117.68 ± 8.21 86.70 ± 6.33
t值 ? 7.616 7.349 1.829 -1.272
P值 ? < 0.001 < 0.001 0.071 0.207
图1 外周血单核细胞平均体积与血清细胞因子IL-1β、IL-6及TNF-α表达水平相关性
表2 各参数的ROC曲线AUC及最佳临界值
参数 AUC 临界值 敏感度(%) 特异度(%)
MMV(fl) 0.899 172.6 80.7 86.1
MDW 0.819 19.7 72.3 69.6
MMC 0.559 118.1 51.8 56.9
MMS 0.626 87.7 59.0 60.8
IL-6(ng/L) 0.922 4.0 84.3 87.3
图2 单核细胞VCS参数诊断APTB的ROC曲线
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