中性粒细胞碱性磷酸酶在传染性非典型肺炎诊断与鉴别诊断中的价值

To approach the value of neutrophils alkaline phosphatase in diagnosis of severe acute respiratory syndrome

目的 探讨中性粒细胞碱性磷酸酶 (alkalinephosphatase ,ALP)活性在传染性非典型肺炎 (严重急性呼吸综合征 ,SARS)患者诊断与鉴别诊断中的应用价值。方法 抽取 138例临床确诊的SARS患者、14 4例除外SARS的其他发热患者和 15 7名正常健康人 (男 80例 ,女 77例 )静脉血 ,制备血涂片。所有血涂片依改良Gomori氏法进行ALP细胞免疫组织化学染色 ,显微镜油镜观察 10 0个中性粒细胞 ,以阳性率和积分记录结果。结果 正常健康人群中性粒细胞碱性磷酸酶染色 (NAP)阳性率和积分中位数均为 10 0 0 ,差异无统计学意义 (P >0 0 5 ,P >0 0 5 ) ;非SARS发热患者组、SARS患者组中性粒细胞ALP阳性率 (中位数 )分别为 4 0 0 0、16 0 0 ,积分分别为 5 0 5 0、17 0 0 ,经统计学处理表明 ,不论NAP阳性率还是积分 ,非SARS发热患者高于SARS患者 ,SARS患者高于正常对照 (P<0 0 1)。结论 正常健康人群、非SARS发热患者、SARS患者间中性粒细胞碱性磷酸酶存在差异 ,将中性粒细胞碱性磷酸酶用于SARS的诊断与鉴别诊断有待进一步观察。

Objective To examinate neutrophils alkaline phosphatase (NAP) in patients with severe acute respiratory syndrome (SARS) and contract with fever patients excepted SARS and normal health people To explore diagnosis value of NAP for SARS Methods We collect vein blood of SARS patients(n=138), fever patients excepted SARS( n =144) and normal health people( n =157, 80 male, 77 female), prepare blood smear and examinate NAP after improved Gomori dyeing with oil mirror of microscope We report result with positive percent and integral record Results The positive percent and integral record(medium value) of NAP in normal health people were 10 It showed no asexual difference ( P >0 05) The positive percent (medium value) of NAP in SARS patients and fever patients excepted SARS were 40 and 16, respectively The integral record (medium value) of NAP in SARS patients and fever patients excepted SARS were 50 50 and 17 00 respectively In both positive percent and integral record, fever patients excepted SARS were lager than SARS patients( P <0 01, P <0 01) and SARS patients were lager than normal health people( P <0 01, P <0 01) Conclusion There were different NAP levels among SARS patients( n =138), fever patients excepted SARS( n =144) and normal health people But we must go on researching for diagnosis of SARS by using NAP