外周血嗜酸性粒细胞在肝移植术后急性排斥反应中的应用价值

Clinical value of peripheral blood eosinophil cells in the diagnosis of acute rejection after orthotopic liver transplantation

目的探讨外周血嗜酸性粒细胞在肝移植术后急性排斥反应中的临床诊断价值。方法回顾性分析中山大学附属第三医院肝移植术后患者的临床资料,根据病理确诊结果将肝移植术后患者分为急性排斥组(28例)和非排斥组(72例),随机抽取40例健康查体者为对照组,测定各组人员的外周血嗜酸性粒细胞的绝对值和百分比。根据受试者工作曲线(ROC)确定嗜酸性粒细胞绝对值和比例的临界值,分析其诊断急性排斥反应的敏感度和特异度。结果急性排斥组、非排斥组、对照组外周血嗜酸性粒细胞阳性率分别为100.00%、11.11%、0.00%,急性排斥组与其他2组比较,差异均有统计学意义(P<0.05)。ROC曲线分析显示,外周血嗜酸性粒细胞绝对值用于诊断肝移植术后急性排斥的临界值为0.295×109/L时,AUC为0.940;嗜酸性粒细胞百分比临界值为8.75%时,AUC为0.978。结论外周血嗜酸性粒细胞可作为肝移植术后患者急性排斥反应的实验室诊断指标。

Objective To explore the clinical value of peripheral blood eosinophil cells in the diagnosis of acute rejection of liver transplantation. Methods Clinical data of liver biopsy in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. According to the pathological diagnosis results,the patients were divided into the acute rejection group（ 28 cases） and the non-acute rejection group（ 72 cases）,and 40 health examinees were selected as the control group. The percentage and absolute value of acid granulocyte in peripheral blood of patients were detected. ROC was used to determine the absolute value of eosinophils and the proportion of the critical value,so as to analyze the sensitivity and specificity of acute rejection. Results The positive rates of peripheral blood eosinophils in the acute rejection group,the non rejection group and the control group were 100. 00%,11. 11% and 0. 00%,respectively. The difference between the acute rejection group and the other two groups was statistically significant（ P〈0. 05）. ROC curve analysis showed that as the critical value of peripheral blood eosinophilia＇s absolute value was 0. 295 × 109/L in the diagnosis of acute rejection after liver transplantation,AUC was 0. 940;when the critical value of eosinophilia proportion was 8. 75%,AUC was 0. 978. Conclusion The peripheral blood eosinophil can be used as an indicator of acute rejection after orthotopic liver transplantation.