布鲁菌病患者的实验室检查指标分析  

Analysis of laboratory indicators in patients with brucellosis

作　　者：李孝 李晓聪 王波 贺娟 石悦 王锐 陈悦彤 丁海涛 LI Xiao;LI Xiaocong;WANG Bo;HE Juan;SHI Yue;WANG Rui;CHEN Yuetong;DING Haitao(Inner Mongolia Clinical Medical College,Inner Mongolia Medical University,Hohhot,Inner Mongolia 010059,China;Clinical Laboratory Medicine Center,Inner Mongolia Autonomous Region People's Hospital,Hohhot,Inner Mongolia 010017,China)

机构地区：[1]内蒙古医科大学内蒙古临床医学院,内蒙古呼和浩特010059 [2]内蒙古自治区人民医院临床检验医学中心,内蒙古呼和浩特010017

出　　处：《热带医学杂志》2025年第1期58-62,75,共6页Journal of Tropical Medicine

基　　金：内蒙古自治区医师协会临床医学研究和临床新技术推广项目(YSXH2024KYF001);内蒙古医学科学院公立医院科研联合基金科技项目(2023GLLH0060);内蒙古自治区卫生健康委医疗卫生科技计划项目(202201054)。

摘　　要：目的探讨实验室检测指标在布鲁菌病诊断和疾病分期中的区分价值。方法在2023年5-6月期间,通过现场流行病学调查收集包头市达茂旗牧区与赤峰市宁城县牧区的布鲁菌病患者资料95例,同时回顾性分析2022年7月-2023年7月内蒙古自治区人民医院门诊收治的49例布鲁菌病患者临床资料。另外选取25名医院体检的健康人群作为对照组。根据发病时间将布鲁菌病患者分为急性期和慢性期,对各组实验室检查指标进行统计学分析。采用单因素logistic回归分析评估影响急慢性布鲁菌病患者分期的独立风险预测因素。采用LASSO回归分析建立基于实验室检查指标判断布鲁菌病患者急慢性分期的模型。采用受试者工作特征(ROC)曲线评估模型判断患者分期的效能。结果发热、乏力和关节痛症状与患者的急慢性分期有显著的关联性(χ^(2)=76.992、10.887、19.472,P均<0.001)。急性期布鲁菌病患者的淋巴细胞绝对值、嗜酸性粒细胞绝对值、血红蛋白、球蛋白、前白蛋白、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶与慢性期患者和正常对照组相比差异均有统计学意义(F=4.516、9.591、22.897、12.371、22.733、10.158、8.327,P均<0.05)。急性期患者降钙素原、C反应蛋白、白介素6与慢性期患者相比差异均有统计学意义(Z=-5.146、-6.294、-6.034,P均<0.05)。单因素logistics分析发现,球蛋白、丙氨酸氨基转移酶和前白蛋白可能是布鲁菌病严重程度相关的独立风险预测因素,且LOSSA回归构建的联合诊断曲线下面积为0.830。结论实验室检查指标可以帮助临床医生评估布鲁菌病患者的急慢性临床分期。前白蛋白、球蛋白和丙氨酸氨基转移酶可能是布鲁菌病临床分期评估中有用的独立风险预测因素。Objective To explore the distinguishing value of laboratory test indicators in the diagnosis and staging of brucellosis.Methods After on-site epidemiological investigation,95 patients with brucellosis were screened and related laboratory tests were performed.In addition,the laboratory results of 49 patients with brucellosis and 25 normal controls collected in the outpatient clinic of the People's Hospital of Inner Mongolia Autonomous Region were retrospectively analyzed.According to the onset time,the patients were divided into acute and chronic,and the laboratory examination indicators were statistically analyzed.Univariate logistic regression analysis was used to evaluate the independent risk predictors affecting the staging of patients with acute and chronic brucellosis disease.LASSO regression analysis was used to establish a model for judging the acute and chronic stages of patients with brucellosis based on laboratory examination indicators.The receiver operator characteristic(ROC)curve was used to evaluate the efficacy of the model to judge the patient staging.Results Symptoms of fever,fatigue,and arthralgia were significantly associated with the acute and chronic stage of the patient(χ^(2)=76.992,10.887,19.472;all P<0.001).The absolute values of lymphocytes,eosinophils,hemoglobin(HB),globulin,prealbumin(PA),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)in acute brucellosis patients showed significant differences when compared to chronic patients and normal controls(F=4.516,9.591,22.897,12.371,22.733,10.158,8.327;all P<0.05).Additionally,the levels of procalcitonin(PCT),C-reactive protein(CRP),and interleukin-6(IL-6)in acute phase patients also showed significant differences when compared to chronic phase patients(Z=-5.146,-6.294,-6.034;all P<0.05).Univariate logistics analysis showed that globulin,ALT and PA might be independent risk predictors related to the severity of brucellosis disease,and the area under the combined diagnostic curve constructed by LOSSA regression was 0.830.Concl

关 键 词：布鲁菌病 球蛋白 丙氨酸氨基转移酶 前白蛋白 

分 类 号：R516.7[医药卫生—内科学]