传染性单核细胞增多症患儿淋巴细胞VCS参数的变化及意义

Research on the changes of lymphocyte VCS parameters and its significance in infants with infections mononucleosis

目的探讨淋巴细胞平均体积、淋巴细胞平均电导和淋巴细胞平均光散射等VCS参数在传染性单核细胞增多症患儿中的变化及意义。方法 Beckman-Coulter LH750全自动血细胞分析仪检测50例传染性单核细胞增多症患儿急性发作期、恢复期及50例健康体检儿童外周血标本,统计分析WBC、L以及MLV、MLC和MLS等VCS参数结果。结果传染性单核细胞增多症急性期WBC、L、MLV、MLC、MLS明显高于恢复期和对照组,差异有统计学意义(P<0.05),传染性单核细胞增多症恢复期各参数与对照组差异无统计学意义(P>0.05)。传染性单核细胞增多症组MLV、MLC与异型淋巴细胞比值(ALY)呈正相关(r=0.315、0.495,P<0.05)。ROC曲线分析MLV、MLC、MLS的曲线下面积分别为0.574、0.911、0.756,其中MLC的cut-off值≥114.1时,敏感性和特异性达86.5%和88.7%。结论传染性单核细胞增多症急性期淋巴细胞VCS参数存在异常变化,在血常规检查的同时提供MLV、MLC、MLS等参数,或有助于传染性单核细胞增多症的临床诊断和病情判断。MLC或可作传染性单核细胞增多症患儿快速诊断的理想指标。

Objective To investigate the changes and clinical significance of lymphocyte VCS parameters in infants with infections mononucleosis（ IM）. Methods The peripheral blood samples from 50 infants with acute or relieved IM and 50 healthy examination infants were collected and analyzed. VCS parameters were detected by Beckman- Coulter LH750 hematology analyzer,such as total white blood cell fount（ WBC）,percentage of lymphocyte（ L）,lymphocyte VCS parameters（ MLV,MLC,MLS）. Results IM,WBC,L,MLV,MLC and MLS of the acute phase were significantly higher than that in the recovery phase of IM and healthy infants,with the differences statistically significant（ P〈0. 05）. There was no statistical significance on the differences in these parameters between healthy infants and IM recovery phase（ P〉0. 05）. Among the infants with IM acute phase,the MLV and MLC were positively correlated with ALY（ r = 0. 315,0. 495,P〈0. 05）. The area under curve of MLV,MLC and MLS were 0. 574,0. 911 and 0. 756 respectively by ROC curve analysis,when the MLC cut- off value was ≥44. 35,its sensitivity and specificity were 86. 5% and 88. 7%. Conclusion There were abnormal changes of lymphocyte VCS parameters at the acute phase of IM,and to provide the parameters of MLV,MLC,MLS with the blood regular determination,which may afford valuable evidence in diagnosis and treatment for IM. MLC may be a good indicator of rapid diagnosis to infants with IM.