甲型H1N1流感病毒与非甲型H1N1流感病毒患者外周血象的对比分析

An analysis of peripheral blood cells in patients with influenza A(H1N1) virus infection or non-H1N1 virus infection

目的:对航天中心医院就诊的甲型H1N1流感病毒感染者与非甲型H1N1流感病毒感染者、正常对照者的外周血象进行对比分析,以期为临床的诊断、治疗以及病情监测提供有利的工具。方法:采用RT-PCR的方法对患者是否患甲型H1N1流感进行确认。采用流式细胞技术的方法,利用全血细胞计数仪对甲型H1N1组、非甲型H1N1组患者以及正常对照组外周血象进行对比分析。利用免疫比浊的方法对3组患者外周血中C反应蛋白(CRP)浓度进行比较分析。结果:甲型H1N1组患者中单核细胞百分数阳性百分率占77.1%,非甲型H1N1组患者单核细胞百分数阳性百分率占7.8%,正常对照组单核细胞百分数阳性百分率占6.7%。甲型H1N1组白细胞总数、淋巴细胞百分比以及嗜酸细胞百分比与非甲型H1N1组相比明显降低,但甲型H1N1组中性粒细胞百分比与正常对照组相比明显升高,而单核细胞百分比在甲型H1N1组中显著升高。甲型H1N1组血小板总数、血小板压积与非甲型H1N1组相比降低,而血小板分布宽度相比非甲型H1N1组数值升高,但与正常对照组相比,血小板总数以及3项参数未有明显差异。甲型H1N1组中CRP浓度与非甲型H1N1组相比差异无显著性,但与正常对照组相比明显升高。结论:甲型H1N1感染患者外周血象与一般流感存在相似之处,但它有其独特特点,在诊断过程中不应该以一般流感的外周血象以及CRP浓度特点来排除甲型H1N1流感病毒的感染。

Objective To analyze the characteristics of peripheral blood in H1N1 patients, non-H1N1 patients, and healthy individuals, to offer favorable tools for clinical diagnosis, treatment and condition monitoring. Methods RT-PCR was used to confirm influenza A H1N1 infection. Peripheral blood cells were detected by flow cytometry in H1N1 patients, non-H1N1 patients, and healthy subjects; CRP levels were determinated by immunoturbidimetry. Results The percentage of monocytes was 77.1% in H1N1 patients, 7.8% in non-H1N1 patients, and 6.7% in healthy subjects. Total WBC count, lymphocyte percentage, and eosinophil percentage were significantly lower in H1N 1 group than in non- N1H1 group, while neutrophil percentage and monocyte percentage were significantly higher in H1N1 group than in the control group. Total platelet count and platelet hematocrit were lower but platelet distribution width was higher in H1N1 group than in non-H1N1 group. As compared with the control group, total platelet count, platelet hematocrit, and platelet distribution did not differ significantly in H1N1 group. CRP levels did not differ significantly between H1N1 group and non- H1N1 group but markedly higher in H1N1 group than in the control group. Conclusions Peripheral blood cells in H1N1 patients have some similarity with common flu but have their own features. We should not exclude the diagnosis of H1N1 virus infection based only on peripheral blood cell count and CRP levels.