切换至 "中华医学电子期刊资源库"

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:
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/OL]. 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/OL]. 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。

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.

表1 APTB组和健康对照组VCS参数(±s)
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
图2 单核细胞VCS参数诊断APTB的ROC曲线
[1]
Wang L, Zhang H, Ruan Y, et al. Tuberculosis prevalence in China, 1990-2010; a longitudinal analysis of national survey data[J].Lancet, 2014,383(9934):2057-2064.
[2]
李红, 唐神结.肺结核患者外周血sIL-2R, TNF-α, IFN-γ, IL-6的检测及意义[J].中国防痨杂志,2011,33(1):57-60.
[3]
谭守勇, 谭耀驹, 黎燕琼, 等.空洞肺结核细胞因子水平测定临床研究[J].中国防痨杂志,2009,31(4):241-243.
[4]
Wu J, Wang S, Lu C, et al. Multiple cytokine responses in discriminating between active tuberculosis and latent tuberculosis infection[J]. Tuberculosis (Edinb),2017,102:68-75.
[5]
Weiss G, Schaible UE. Macrophage defense mechanisms against intracellular bacteria[J]. Immunol Rev,2015,264(1):182-203.
[6]
Castaño D,Barrera LF,Rojas M.Mycobacterium tuberculosisalters the differentiation of monocytes into macrophages in vitro [J].Cell Immunol,2011,268(2):60-67.
[7]
Pasula R,Martin WJ 2nd,Kesavalu BR, et al.Passive transfer of interferon-γover-expressing macrophages enhances resistance of SCID mice toMycobacterium tuberculosisinfection[J]. Cytokine,2017,95:70-79.
[8]
刘艳华, 王若, 程小星.活动性结核患者单核来源巨噬细胞中C-X-C型趋化因子受体4的表达研究[J].国际呼吸杂志,2017,37(3):178-182.
[9]
Zhu Y, Cao Xu, Chen Y, et al.Neutrophil cell population data: useful indicators for postsurgical bacterial infection[J]. Int J Lab Hematol,2012,34(3):295-299.
[10]
Shen T,Gu D,Zhu Y, et al. The VCS parameters: potential hematological indicators for predicting antituberculosis drug-induced neutropenia[J]. Clin Chim Aata,2016,459:147-149.
[11]
Zhou N,Liu L,Li D, et al.VCS parameters of neutrophils, monocytes and lymphocytes may indicate local bacterial infection in cancer patients who accepted cytotoxic chemotherapeutic[J]. Eur J Clin Microbiol Infect Dis,2016,35(1):41-48.
[12]
吴妹英, 王霞芳, 肖玉梅, 等.酶联免疫斑点法在快速诊断活动性肺结核中的应用[J/CD].中华实验和临床感染病杂志(电子版),2009,3(2):125-130 .
[13]
陈兴年, 刘奇栋, 王泓, 等.活动性肺结核患者血清中白细胞介素6, 8和肿瘤坏死因子α检测的临床意义[J].中国防痨杂志,2015,37(4):344-347.
[14]
Saini NK,Sinha R,Singh P, et al. Mce4A protein ofMycobacterium tuberculosisinduces proinflammatory cytokine response leading to macrophage apoptosis in a TNF-αdependent manner[J]. Microb Pathog,2016,100:43-50.
[15]
Monin L,Khader SA. Chemokines in tuberculosis: the good, the bad and the ugly[J]. Semin Immunol,2014,26(6):552-558.
[16]
Shrivastava P,Bagchi T. Differential expression of alphaⅡspectrin in monocytes of tuberculosis patients[J]. Int Immunopharmaacol,2013,17(3):759-762.
[17]
Chowdhury IH,Ahmed AM,Choudhuri S, et al. Alteration of serum inflammatory cytokines in active pulmonarytuberculosis following anti-tuberculosisdrug therapy[J]. Mol Immunol,2014,62(1):159-168.
[18]
Chandrashekara S,Anupama KR,Sambarey A, et al. High IL-6 and low IL-15 levels mark the presence of TB infection: A preliminary study[J].Cytokine,2016,81:57-62.
[19]
Shrivastava P,Bagchi T. Difference in mononuclear cell cytokine profile of tuberculosis patients before and after treatment and its influence on in vitro multinucleate giant cell formation[J]. Hum Immunol,2016,7(6):516-521.
[20]
Cambier CJ, Falkow S, Ramakrishnan L. Host evasion and exploitation schemes ofMycobacterium tuberculosis[J]. Cell,2014,159(7):1497-1509.
[21]
Dey B, Bishai WR. Crosstalk betweenMycobacterium tuberculosisand the host cell[J]. Semin Immunol,2014,26(6):486-496.
[22]
Castaño D,Barrera LF,Rojas M.Mycobacterium tuberculosisalters the differentiation of monocytes into macrophages in vitro[J]. Cell Immunol,2011,268(2):60-67.
[23]
范玉平, 朱易华, 曹兴建.中性粒细胞体积参数在诊断重型颅脑外伤并发败血症中的价值[J/CD].中华临床医师杂志(电子版),2016,10(3):317-320.
[24]
Aoyama T, Matsumoto T, Uchiyama A, et al. Recurrent severe acute hepatitis caused by hypereosinophilic syndrome associated with elevated serum immunoglobulin G4 levels[J]. Clin J Gastroenterol,2014,7(22):516-522.
[25]
Zhu Y, Cao X, Zhang K, et al. Delta mean neutrophil volume (△MNV) is comparable to procalcitonin for predicting postsurgical bacterial infection[J]. Clin J Lab Analy,2014,28(4):301-305.
[1] 何欣林, 阎昊铮, 赵亦非, 江彩霞, 李征宇. 新辅助化疗联合间歇性肿瘤细胞减灭术对上皮性卵巢癌患者预后及血清学与影像学指标对患者预后的预测价值[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(01): 47-57.
[2] 李可心, 鲁瑞, 田燕, 王文俊, 李维, 万月强, 翟嵩, 刘拉羊. 阿达木单抗治疗银屑病致播散性肺结核一例并文献复习[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(04): 245-249.
[3] 张燕, 杨跃青, 邱峥. IgG 联合血清细胞因子对肺结核并发慢性肺曲霉菌病的诊断意义[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 809-812.
[4] 白若靖, 郭军. 维生素D对肺部疾病临床意义的研究进展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(04): 659-662.
[5] 董学峰, 常乐, 蔡振煜. 血清ESR、CRP及PLR、MLR联合诊断结缔组织相关性间质性肺炎的意义[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 430-433.
[6] 蒋丽芳, 林冰. 桑菊清解汤联合左氧氟沙星治疗社区获得性肺炎的临床分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 458-461.
[7] 沙敏, 瞿秋霞, 朱卫东, 陈成. 肺结核与肺结节病相关肉芽肿组织中CXCR5的差异性表达[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(02): 189-194.
[8] 徐辉, 杨勇琼, 刘健, 许剑, 江佳莲, 邓正波. s-ChE、PCT、CRP在肺结核中的表达及继发肺部感染的预测意义[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(02): 292-295.
[9] 傅红兴, 王植楷, 谢贵林, 蔡娟娟, 杨威, 严盛. 间充质干细胞促进胰岛移植效果的研究进展[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(06): 351-360.
[10] 徐嘉愉, 张复华, 牛国敏, 梁家宝, 潘焕玉, 麦秀蕖, 杨国雷, 徐嘉良, 黄佑勇. Th1/Th2细胞因子谱在恶性血液肿瘤患者化疗后中性粒细胞缺乏伴感染的应用价值[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(03): 143-150.
[11] 阿卜杜萨拉木·图尔荪麦麦提, 吐尔洪江·吐逊, 温浩. 肝脏缺血-再灌注损伤与cGAS-STING信号通路[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 394-397.
[12] 杨智钧, 谷佳, 丁聿贤, 张正奎, 于如同. 脑胶质瘤患者血清炎性因子水平与病理分级及预后的相关性[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(04): 238-242.
[13] 丛黎, 马林, 陈旭, 李文文, 张亮亮, 周华亭. 改良CT严重指数联合炎症指标在重症急性胰腺炎患者胰腺感染预测及预后评估中的研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 432-436.
[14] 李益军, 梁兴森, 方细霞, 肖文良, 李湘, 高彦平, 李嘉, 李玲. 温针灸治疗早中期寒湿痹阻型膝骨关节炎的疗效观察[J/OL]. 中华针灸电子杂志, 2024, 13(01): 7-12.
[15] 徐韫健, 吴柳, 尹小毛. 结核病γ-干扰素释放试验假阴性的影响因素分析[J/OL]. 中华临床实验室管理电子杂志, 2024, 12(02): 75-79.
阅读次数
全文


摘要