血常规参数在儿童传染性单核细胞增多症中的诊断价值  

Diagnostic value of routine blood parameters in children with infectious mononucleosis

作　　者：马聪 栗春香 史利欢 路俊锋 王平平 MA Cong;LI Chunxiang;SHI Lihuan;LU Junfeng;WANG Pingping(Department of Medical Laboratory,Luoyang Maternal and Child Health Hospital,Luoyang,Henan 471000,China;Department of Hematology and Oncology,Henan Children's Hospital,Zhengzhou,Henan 450018,China;Department of Emergency Medicine,Luoyang Maternal and Child Health Hospital,Luoyang,Henan 471000,China)

机构地区：[1]洛阳市妇幼保健院医学检验科,河南洛阳471000 [2]河南省儿童医院血液肿瘤科,河南郑州450018 [3]洛阳市妇幼保健院急诊医学科,河南洛阳471000

出　　处：《中国医学工程》2024年第2期12-17,共6页China Medical Engineering

基　　金：河南省医学科技攻关联合共建项目(2018020613)。

摘　　要：目的研究血常规参数在儿童传染性单核细胞增多症(IM)中的诊断价值。方法回顾性收集2021年6月至2022年10月在洛阳市妇幼保健院初诊为儿童传染性单核细胞增多症(IM)患者60例为研究组,并选取同时期在该院体检的健康儿童40例为对照组。对入组患者的一般资料和实验室检查进行统计分析,比较各指标的差异。分析两组患者的白细胞(WBC)、中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)以及淋巴细胞群落参数:淋巴细胞复杂程度(L-X)、淋巴细胞荧光强度(L-Y)、淋巴细胞大小(L-Z)的表达差异。根据是否确诊为儿童IM,将研究组分为A组(IM组)和B组(巨细胞病毒及其他感染组),比较A组和B组的NLR、MLR以及L-X、L-Y、L-Z的差异。采用受试者工作特征(ROC)曲线分析NLR、MLR以及淋巴细胞群落参数L-Y、L-Z对IM患者的诊断和预测价值。结果研究组CRP、WBC显著高于对照组,NLR、MLR显著低于对照组(P<0.05)。研究组的淋巴细胞群落参数L-Y、L-Z均显著高于对照组(P<0.05),研究组与对照组的淋巴细胞群落参数L-X差异无统计学意义(P>0.05)。A组的L-Y、L-Z显著高于B组(P<0.05),NLR、MLR显著低于B组(P<0.05),CRP、异型淋巴细胞比例、L-X参数A、B两组比较,差异无统计学意义(P>0.05)。ROC曲线分析NLR、MLR、淋巴细胞群落参数L-Y、L-Z预测IM的敏感性分别为0.806、0.889、0.694、0.750,特异性分别为0.828、0.703、0.937、0.891,曲线下面积分别为0.889、0.868、0.862、0.877,最佳截断值分别为0.485、0.095、803.1、961.85。结论血细胞参数NLR、MLR以及淋巴细胞群落参数L-Y、L-Z分别表达机体的免疫功能状态以及量化细胞内部结构变化,更敏感反映儿童IM疾病的改变,可优化儿童IM的临床诊断方案,对儿童IM有较高的诊断价值,可作为诊断该疾病的重要参考指标。【Objective】To study the diagnostic value of routine blood parameters in the diagnosis of infectious mononucleosis(IM)in children.【Methods】Sixty patients with childhood infectious mononucleosis(IM)initially diagnosed in Luoyang Maternal and Child Health Hospital from June 2021 to October 2022 were retrospectively collected as the study group,and 40 healthy children who were examined in the hospital during the same period were selected as the control group.The patients'general data and laboratory tests were analyzed to compare the differences between the two groups,and to analyze the expression differences in white blood cells(WBC),neutrophil/lymphocyte ratio(NLR),monocyte/lymphocyte ratio(MLR),and lymphocyte community parameters[lymphocyte complexity(L-X),lymphocyte fluorescence intensity(L-Y),lymphocyte size(L-Z)]between the two groups.The study group was divided into group A(IM group)and group B(cytomegalovirus and other infections group)according to whether the diagnosis of IM in children was confirmed,and the differences in NLR,MLR,L-X,L-Y,and L-Z between group A and group B were compared.Diagnostic and predictive value of NLR,MLR,and lymphocyte community parameters L-Y and L-Z for IM patients was analyzed using receiver operating characteristic(ROC)curve.【Results】WBC of the study group were significantly higher than those of the control group,and NLR and MLR were significantly lower than those of the control group(P<0.05).Lymphocyte colony parameters L-Y and L-Z of the study group were significantly higher than those of the control group(P<0.05),and the difference in lymphocyte colony parameter L-X between the study group and the control group was not significant(P>0.05).L-Y and L-Z in group A were significantly higher than those in group B(P<0.05),NLR and MLR were significantly lower than those in group B(P<0.05),and the differences in CRP,heterogeneous lymphocyte ratio and L-X were not significant between the two groups(P>0.05).The sensitivity of NLR,MLR and lymphocyte community parameters L-Y a

关 键 词：中性粒细胞/单核细胞比值 淋巴细胞/单核细胞比值 淋巴细胞群落参数 传染性单核细胞增多症 

分 类 号：R725.1[医药卫生—儿科]