氧化锌中毒患者中性粒细胞VCS参数分布特征及意义

Distribution characteristics and clinical significance of neutrophil VCS parameters in patients with zinc oxide toxicosis

目的观察氧化锌中毒患者中性粒细胞VCS参数,探讨其对氧化锌中毒鉴别诊断的临床意义。方法用LH-750血液分析仪检测120例氧化锌中毒患者、50例细菌感染患者及60例健康对照者的外周血中性粒细胞VCS参数,包括中性粒细胞平均体积(MNV)、中性粒细胞体积分布宽度(NDW)、中性粒细胞平均传导率(MNC)和中性粒细胞平均散射值(MNS)等。治疗前后分别检测氧化锌中毒患者的VCS参数。结果氧化锌中毒组MNV高于细菌感染组和健康人对照组,中毒组MNC低于细菌感染组和健康人对照组,差异均有统计学意义(P均<0.01);MNC cut-off值<144.70时,鉴别诊断的敏感性为90.83%,特异性为98.33%,高于WBC计数和其他VCS参数;氧化锌中毒患者中WBC≥10.0×109/L组和WBC<10.0×109/L组MNC分别为140.05±4.26和138.87±5.87,二者差异无统计学意义(P>0.05);MNC在治疗3 d后回升。结论中性粒细胞参数MNC在氧化锌中毒时变化与形态学改变相符,在治疗后回升,可作为氧化锌中毒的诊断与治疗监测指标。

Objective To observe the clinical value of neutrophil VCS parameters in the patients with zinc oxide toxicosis. Methods The peripheral blood samples from 120 patients with zinc oxide toxicosis,50 patients with bacteria infection and 60 healthy subjects were tested using Coulter LH 750 hematology analyzer. VCS parameters,including mean neutrophil volume（ MNV）,neutrophil distribution width（ NDW）,mean neutrophil conductivity（ MNC） and mean neutrophil scattering value（ MNS）,were examined before and after treatment. Results MNV in patients with zinc oxide toxicosis increased significantly compared with those of healthy group and bacterial-infectious group. On the contrary,MNC decreased significantly in the patients with zinc oxide toxicosis compared with that of healthy group and bacterial infection patients. There was significant statistical difference between the two groups（ P〈0. 01）. When the cut-off value is less than 144. 70,the sensitivity and specificity of differential diagnosis are 90. 83%,98. 33%,respectively,higher than those of WBC count and other VCS parameters. The values of MNC in WBC greater than or equal to 10. 0 × 10^9/L group and WBC less than 10. 0 × 10^9/L group were（ 140. 05 ± 4. 26） and（ 138. 87 ± 5. 87） respectively. There was no significant difference between the two groups（ P〈0. 05）. The values returned to normal range after treatment for 3 days. Conclusion The MNC of neutrophil may reflect the morphologic change of neutrophils in zinc oxide toxicosis and restore its normal value after treatment,so it can be used as a marker for diagnosis and monitoring of disease.