嗜酸性粒细胞群落参数在中药治疗银屑病药物性肝损伤监测中的作用

Analysis of Eosinophils Morphological Parameter in the Monitoring of Chinese Medicine Drug-induced Liver Injury in Psoriasis

目的研究中药治疗银屑病患者外周血嗜酸性粒细胞群落参数变化及监测药物性肝损伤中的临床意义。方法回顾性收集西安交通大学第二附属医院皮肤科门诊中药治疗银屑病患者100例(其中药物性肝损伤组50例,病例对照组50例)和50例健康查体者(健康对照组)血常规结果。统计分析血常规中嗜酸性粒细胞计数(eosinophil counts,EO#)、嗜酸性粒细胞比例(percentage of eosinophil,EO%)、嗜酸性粒细胞群落参数(嗜酸性粒细胞平均体积Mean eosinophil volume,MEV;嗜酸性粒细胞平均激光散射值Mean eosinophil scatter,MES;嗜酸性粒细胞平均高频传导率Mean eosinophil conductivity,MEC);同时检测三组的血清中丙氨酸氨基转移酶(alanine aminotransferase,ALT)水平,。比较各组之间外周血嗜酸性粒细胞比例和群落参数的差异。结果药物性肝损伤(drug-induced liver injury,DILI)组、病例对照组、健康对照组ALT分别为(232.5±12.3)U/L,(36.6±16.3)U/L,(29.6±26.3)U/L;MEV三组分别为(169.9±5.43)channel,(166.7±9.12)channel,(163.4±4.60)channel,三组之间两两比较差异具有统计学意义(P<0.001);MES三组分别为(205.6±1.56)channel,(206.9±1.95)channel,(207.01±1.73)channel,三组之间两两比较差异具有统计学意义(P<0.001);EO%和EO#三组之间差异无统计学意义(P>0.05)。结论中药治疗银屑病引起肝损伤时,嗜酸性粒细胞体积参数和颗粒度参数变化明显,可以作为一个备用的监测指标运用。

Objective To study the changes of parameters of eosinophils in peripheral blood of patients with psoriasis and to evaluate the clinical significance of monitoring the drug induced liver injury.Methods The datas were been retrospectively collected which was from the outpatient department of Dermatology the Second Affiliated Hospital of Xi＇an Jiao Tong University.That included 100 patients with psoriasis by traditional Chinese medicine treatment（one group was 50 cases of drug-induced liver injury and the case control group was another 50 cases）, and 50 cases of healthy physical examination（healthy control group）.The blood eosinophil counts（eosinophlis counts, EO#）, eosinophils percentage（percentage of eosinophlis, EO%）and eosinophils morphological parameter was statistical analyzed; the serum alanine aminotransferase（ALT）in two groups was been detected, then these datas were been compared in each group.Results In drug induced liver injury（DILI）group, the level of ALT was（232.5＋12.3）U/L, case control group was（36.6＋16.3）U/L, healthy control group was（29.6＋26.3）U/L; MEV respectively were（169.9＋5.43）channel,（166.7＋9.12）channel,（163.4＋4.60）channel, and between the three groups was statistically significant difference（P〈0.001）; MES respectively were（205.6＋1.56）channel,（206.9＋1.95）channel,（207.01＋1.73）channel, and between the three groups was statistically significant difference（P〈0.001）; EO% and EO# were not different between the three groups with statistical significance（P〉0.05）.Conclusion The parameters of the volume and granularity of eosinophils are obviously changed in the treatment of liver injury caused by psoriasis, which can be used as an alternative monitoring indicator.