甲型H1N1流感病例的血液学特点及临床分析  

Hematological characteristics of patients with influenza A （ H1N1 ）

作　　者：王剑超[1] 张永为[1] 马春芳[1] 汪强[1] 郑晓燕[2] 

机构地区：[1]浙江中医药大学附属第二医院检验科,杭州310005 [2]浙江省衢州市人民医院检验科

出　　处：《中华临床感染病杂志》2010年第1期19-22,共4页Chinese Journal of Clinical Infectious Diseases

基　　金：浙江省教育厅基金资助项目（Y200805826）

摘　　要：目的分析甲型H1N1流感患者的血液学特点。方法选择82例甲型H1N1流感患者、60例季节性流感患者和60名健康体检者，采用血细胞分析仪体积法、高频传导和激光散射法（VCS）技术对白细胞进行分类，统计分析白细胞总数（WBC）、淋巴及单核细胞百分比、平均淋巴细胞体积（MLV）、淋巴细胞体积变异度（LVD）、平均单核细胞体积（MMV）及单核细胞体积变异度（MVD）。组间计量资料差异比较采用ANOVA方差分析，两两比较采用q检验。结果甲型H1N1流感组，季节性流感组和健康对照组的WBC计数分别为（5．7±1．8）×10^9／L、（5．2±1．6）×10^9／L和（6．0±1．3）×10^9／L，比较差异无统计学意义（F=1．55，P〉0．05）；淋巴细胞百分比分别为（17．8±6．3）％、（34．6±7．3）％和（28．7±4．1）％，差异有统计学意义（F=38．36，P〈0．01）；单核细胞百分比分别为（13．2±4．4）％、（9．0±2．5）％和（6．3±1．4）％，差异有统计学意义（F=29．40，P〈0．01）。在WBC VCS参数分析中，甲型H1N1流感患者的MLV和LVD与健康对照组相近（q值分别为0．97和0．43，P值均〉0．05），但明显低于季节性流感组（q值分别为5．69和6．46，P值均〈0．01）；而MMV和MVD均显著高于健康对照组和季节性流感组（F值分别为40．72和32．51，P值均〈0．01）。结论甲型H1N1流感早期，患者的血液学变化主要是淋巴细胞比例降低，单核细胞比例增高，而WBC总数无显著变化，能够灵敏地反映外周血淋巴细胞应激性形态改变的MLV和LVD低于季节性流感，反映单核细胞体积变化的形态学参数MMV和MVD增大。Objective To investigate the hematological characteristics of patients with influenza A （ H1N1 ）. Methods Eighty-two patients with influenza A （ H1N1 ） , 60 patients with seasonal influenza and 60 healthy controls were enrolled in the study. Volume, conductivity and scatter （VCS） technique was used to classify leucocytes, and the parameters like white blood cell （WBC） count, percentage of lymphocytes and monoeytes, mean lymphocyte volume （MLV） , lymphocyte volume deviation （LVD） , mean monoeyte volume （MMV） and monoeyte volume deviation （MVD） were analyzed. ANOVA （analysis of variance） was used to compare the measurement data among groups, while q test was performed for pairwise comparison. Results WBC counts in influenza A （H1N2 ） , seasonal influenza and healthy control groups were （5.7 ±1.8） ×10^9/L, （5.2 ± 1.6） × 10^9/L and （6.0 ± 1.3） × 10^9/L, respectively, and the difference was of no statistical significance （F = 1.55, P 〉 0.05 ） ; the percentage of lymphoeytes in three groups were （17.8 ±6.3 ） % , （34.6 ±7.3 ） % and （28.7 ±4.1 ） % , the difference was of statistical significance （ F = 38.36, P 〈 0.01 ） ; the percentage of monocytes in three groups were （13.2 ± 4.4）% , （9.0 ±2.5 ）% and （6.3 ±1.4）%, and the value in influenza A （H1N1 ） group was significantly higher than those in the other two groups （ F = 29.40, P 〈 0.01 ）. MLV and LVD in the influenza A （ H1 N1 ） group were similar with those in the healthy controls （ q = 0.97 and 0.43, P 〉 0.05 ） , but were significantly lower than those in the seasonal influenza group （q = 5.69 and 6.46, P 〈 0.01 ）. MMV and MVD were significantly higher in the influenza A （H1N1） group thanin the other twogroups （F=40.72 and 32.51, P〈0.01）. Conclusions Influenza A （ H1 N1 ） is characterized by the decrease of lymphocytes percentage and increase of monocytes percentage in the early stage and the WBC count is nearly at the normal leve

关 键 词：流感 人 流感病毒A型 H1N1亚型 血常规指标 VCS参数 

分 类 号：R51[医药卫生—内科学]