异型淋巴细胞与白细胞VCS参数在传染性单核细胞增多症伴早期肝功能损害中的评估价值

Evaluation value of leukocyte VCS parameter and heterogeneous lymphocytes in infectious mononucleosis with early liver function impairment

目的探讨异型淋巴细胞、白细胞VCS参数在传染性单核细胞增多症(IM)伴早期肝功能损害中的评估价值。方法选取2019年6月至2021年7月本院收治的90例IM患儿作为观察组,选取同期于本院治疗的40例IM伴早期肝功能损害患儿作为肝损害组,另选取同期于本院进行健康体检的50名儿童作为对照组。3组均行血清淀粉样蛋白A(SAA)水平检测、外周血涂片细胞学检查、白细胞VCS分析,比较3组外周血细胞形态学检测结果及急性期、恢复期血清SAA水平、白细胞VCS相关参数[单核细胞平均激光散射(MMS)、单核细胞平均高频传导(MMC)、单核细胞平均体积(MMV)、淋巴细胞平均激光散射(MLS)、淋巴细胞平均高频传导(MLC)、淋巴细胞平均体积(MLV)]。结果3组急性期和恢复期的血清SAA水平及异型淋巴细胞>10%占比比较差异有统计学意义(P<0.05),3组凋亡淋巴细胞占比比较差异无统计学意义;观察组异型淋巴细胞>10%占比高于肝损害组、对照组,肝损害组高于对照组,差异有统计学意义(P<0.05);恢复期,观察组与肝损害组SAA水平均低于急性期,差异有统计学意义(P<0.05);急性期、恢复期,观察组SAA水平低于肝损害组,高于对照组,肝损害组高于对照组,差异有统计学意义(P<0.05)。3组急性期和恢复期MMV、MLV、MLC、MMC比较差异有统计学意义(P<0.05),3组急性期和恢复期MLS、MMS比较差异无统计学意义;恢复期,观察组与肝损害组MMV、MLV均小于急性期,观察组MMC高于急性期,差异有统计学意义(P<0.05),观察组MMV、MLV均小于肝损害组,MMC高于肝损害组,肝损害组MMV大于对照组,MLC、MMC均低于对照组,差异有统计学意义(P<0.05);急性期,观察组MMV、MLV均小于肝损害组,MLC、MMC均低于对照组,肝损害组MMV、MLV均大于对照组,MLC、MMC均低于对照组,差异有统计学意义(P<0.05);其他组间各指标不同时期两两比较差异无统计学意义。结论异型淋巴细胞比例在IM和肝功能损害患儿中明显升高,当人体感染EB病毒后,单核细胞VCS参数会出现明显改变,有利于疾病的诊断,因此,异型淋巴细胞和白细胞VCS参数在对IM伴肝功能损害患儿早期疾病的诊断、病情严重程度等方面具有较高的临床价值。

Objective To investigate evaluation value of leukocyte VCS parameter and heterogeneous lymphocytes in infectious mononucleosis(IM)with early liver function impairment.Methods 90 children with IM admitted to our hospital from June 2019 to July 2021 were selected as the observation group,40 children with IM with early liver function impairment treated in our hospital during the same period were selected as the liver injury group,and 50 children who underwent physical examination in our hospital during the same period were selected as the control group.All three groups underwent serum amyloid A(SAA)level detection,peripheral blood smear cytology examination,and white blood cell VCS analysis,the results of peripheral blood cell morphology detection,serum SAA levels during acute and recovery periods and leukocyte VCS related parameters(mean monocytes laser scattering[MMS],mean monocytes high frequency conduction[MMC],monocyte mean volume[MMV],mean lymphocytes laser scattering(MLS),mean lymphocytes high frequency conduction[MLC],mean lymphocyte volume[MLV])were compared among the three groups.Results There were statistically significant differences in serum SAA level and the proportion of heterogeneous lymphocytes>10%among the three groups in the acute stage and the recovery stage(P<0.05),there was no significant difference in the proportion of apoptotic lymphocytes among the three groups;the proportion of heterogeneous lymphocytes>10%in the observation group was higher than that in the liver injury group and the control group,and the liver injury group was higher than that in the control group,and the differences were statistically significant(P<0.05);in the recovery stage,the SAA level in the observation group and the liver injury group was lower than that in the acute stage,and the differences were statistically significant(P<0.05);in acute stage and recovery stage,SAA level in the observation group was lower than that in the liver injury group and higher than control group,and the differences were statistically significant(P<0.05).There were statistically significant differences in MMV,MLV,MLC and MMC among the three groups in the acute stage and the recovery stage(P<0.05),but there were no statistically significant differences in MLS and MMS between the acute stage and the recovery stage;in the recovery stage,MMV and MLV in the observation group and the liver injury group were lower than in the acute stage,and MMC in the observation group was higher than the acute stage,and the differences were statistically significant(P<0.05);MMV and MLV in the observation group were lower than the liver injury group,MMC was higher than the liver injury group,MMV in the liver injury group was greater than that in the control group,and MLC and MMC were lower than that in the control group.the differences were statistically significant(P<0.05);in the acute stage,MMV and MLV in the observation group were lower than the liver injury group,MLC and MMC were lower than the control group,MMV and MLV in the liver injury group were greater than the control group,and MLC and MMC were lower than the control group,the differences were statistically significant(P<0.05);there was no significant difference between other groups in pairwise comparison at different periods.Conclusion The proportion of heterologous lymphocytes is significantly increased in children with IM and liver function impairment,after human infection with EB virus,leukocyte VCS parameter of monocytes will change significantly,which is conducive to the diagnosis of disease,therefore,leukocyte VCS parameter of heterologous lymphocytes and leukocytes have high clinical value in the early diagnosis and severity of disease in children with IM complicated with liver function impairment.