乙肝病毒感染患者血液淋巴细胞和单核细胞VCS参数变化研究

The changes of VCS parameters of lymphocytes and monocytes in HBV infected patients

目的:分析淋巴细胞和单核细胞VCS参数在乙型肝炎病毒感染中变化,探讨其在乙肝病毒感染中应用价值。方法:使用血液分析仪检测乙肝携带者113例,活动性乙肝患者37例,正常对照者526例外周血淋巴和单核细胞的各项VCS参数,并设计一个新指标:淋巴细胞的平均体积×体积标准差/淋巴细胞的平均射频电导率(LYV×LV-SD/LYC),对各指标进行组间比较分析。结果:与对照组相比,乙肝病毒携带者LYV×LV-SD/LYC显著增大(14.38±2.81 vs 11.93±1.36,P<0.01),在乙肝活动组该指标的增大幅度更明显(18.61±3.81 vs 11.93±1.36,P<0.01)。乙肝病毒感染者单核细胞体积参数(MOV)增加较为显著(携带组比正常组:170.53±5.05 vs 168.72±5.05,P<0.01;活动组比正常组:183.27±9.10 vs 168.72±5.05,P<0.01)。LYV×LV-SD/LYC在携带组临界值为≥12.84及在活动组为≥14.87时,其敏感性和特异性分别为:67.26%和82.51%,89.19%和72.57%。结论:乙型肝炎病毒引起了淋巴细胞、单核细胞VCS参数发生显著性变化,转换的淋巴细胞新参数在乙肝患者出现显著增大,在乙肝病毒感染诊治中有临床应用价值。

Objective：To investigate changes of VCS parameters of peripheral lymphocytes and monocytes in Hep- atitis B virus infected patients. Methods：37 active HBV infected patients, 113 HBV carriers and 526 normal healthy controls were included in the study. All peripheral blood specimens were analyzed by using Coulter LH 750. Lymphocyte and monocyte VCS data were collected. One simplified parameter, Lymph-index was defined as （Lymphocyte volume x Lym- phocyte volume-SD/ Lymphocyte conductivity）. Statistical analyses were performed by using SPSS version 13.0 software. Results：A significant increase in Lymph-Index was observed in HBV carriers compared to controls （14.38±2.81 vs 11.93±1.36; t=13.82,P=0.000）. The more pronounced increase was observed in active HBV infected patients （18.61±3.81 vs 11.93±1.36; t=24.1, P=0.000）. MOV was significantly increased in HBV carriers and active patients compared to controls （170.53±5.05 and 183.27±9.10 vs 168.72±5.05; t=3.457 and t=15.82, P〈0.01）. By using cut-off value of ≥ 12.84 and ≥ 14.87 for Lymph-Index, the sensitivity and specificity for diagnosing HBV carriers and active hepatitis were 67.26%, 82.51% and 89.19%, 72.57%. Conclusion：The VCS parameters of lymphocytes and monocytes have significant changes because of HBV infection. Lymph-Index was significantly increased in HBV infection, and it is highly possible that Lymph- Index is a potentially useful target in aid to rapidly diagnose HBV infection in the high HBV prevalence population.