天津医药 ›› 2024, Vol. 52 ›› Issue (4): 391-396.doi: 10.11958/20230779

• 临床研究 • 上一篇    下一篇

布鲁氏菌病患者外周血白细胞及血小板参数的变化及临床意义

乔坤艳1(), 刘韦娜1, 郑晓雅1, 苏瑞1, 杨悦杰2,()   

  1. 1 天津市第二人民医院,天津市肝病医学研究所(邮编300192)
    2 天津市第二人民医院感染科
  • 收稿日期:2023-05-23 修回日期:2023-07-18 出版日期:2024-04-15 发布日期:2024-04-19
  • 通讯作者: E-mail:765833720@qq.com
  • 作者简介:乔坤艳(1987),女,助理研究员,主要从事感染病分子及免疫相关研究。E-mail:qiaokunyan@163.com
  • 基金资助:
    天津市医学重点学科(专科)建设资助项目(TJYXZDXK-059B)

Changes and clinical significance of white blood cell and platelet parameters of peripheral blood in Brucellosis patients

QIAO Kunyan1(), LIU Weina1, ZHENG Xiaoya1, SU Rui1, YANG Yuejie2,()   

  1. 1 Tianjin Institute of Hepatology, Tianjin Second People's Hospital, Tianjin 300192, China
    2 Department of Infectious Disease, Tianjin Second People's Hospital
  • Received:2023-05-23 Revised:2023-07-18 Published:2024-04-15 Online:2024-04-19
  • Contact: E-mail:765833720@qq.com

摘要:

目的 研究布鲁氏菌病患者外周血白细胞及血小板参数的变化及其特点,探讨其临床应用价值。方法 纳入确诊布鲁氏菌病的患者90例,其中急性期59例,慢性期31例,另外选取同期40例健康人群为健康对照组。收集患者的临床症状等基本资料;采用全自动血液分析仪检测各组外周血白细胞计数、淋巴细胞计数、中性粒细胞计数、单核细胞计数、血小板计数、平均血小板体积(MPV)、血小板分布宽度(PDW);采用流式细胞仪检测外周血CD3+T、CD4+T及CD8+T细胞计数,计算患者的中性粒细胞/淋巴细胞比值(NLR)及血小板/淋巴细胞比值(PLR),分析各细胞参数的变化特点并分析各参数对布鲁氏菌病的临床诊断价值。结果 慢性期组的关节痛和脊柱炎占比高于急性期组(P<0.05);与健康对照组相比,急性期组的白细胞计数、中性粒细胞计数、血小板计数及NLR均降低,慢性期组MPV和PDW降低,而CD3+T细胞计数和单核细胞计数升高(P<0.05)。有关节炎症状的急性期布病患者白细胞计数、淋巴细胞计数、CD3+T细胞计数和CD8+T细胞计数低于无关节炎的急性期布病患者,而PLR则升高(P<0.05)。受试者工作特征(ROC)曲线分析结果显示中性粒细胞计数和NLR水平对于急性期布鲁氏菌病的ROC曲线下面积(AUC)分别为0.780和0.717,而CD3+T细胞计数对于诊断慢性期布鲁氏菌病的AUC为0.748。在急性期患者中,CD3+T、CD8+T细胞计数及PLR水平对诊断关节炎的AUC分别为0.779、0.768、0.722。结论 急性期和慢性期布鲁氏菌病患者外周血白细胞和血小板参数均有不同程度的改变,对于布鲁氏菌病的诊断以及急性期布病患者关节炎的诊断有一定的临床应用价值。

关键词: 布鲁杆菌病, 白细胞计数, 血小板计数, 关节炎, 曲线下面积

Abstract:

Objective To study changes of white blood cell (WBC) and platelet parameters in peripheral blood of Brucellosis patients so as to explore the clinical significance. Methods A total of 90 patients with confirmed Brucellosis were included, including 59 in the acute stage and 31 in the chronic stage. In addition, 40 healthy people during the same period were selected as the healthy control group. Basic data such as clinical symptoms were collected. Total WBC count, lymphocyte count, neutrophil count, monocyte count, platelet count, mean platelet volume (MPV) and platelet distribution width (PDW) in peripheral blood were detected by automatic blood analyzer. The counts of CD3+T, CD4+T and CD8+T cells in peripheral blood were detected by flow cytometry. Neutrophil-lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) of patients were calculated. Changes of each cell parameter were analyzed and the clinical diagnostic value of each parameter for Brucellosis were analyzed. Results The proportion of arthralgia and spondylitis were higher in the chronic stage group than those in the acute stage group (P<0.05). Compared with the healthy control group, the total number of WBC, neutrophil count, platelet count and NLR were decreased in the acute stage group, and MPV and PDW were decreased in the chronic stage group, and CD3+T cell count and monocyte count were increased (P<0.05). White blood count, lymphocyte count, CD3+T cell count, and CD8+T cell count were lower in patients with acute Brucellosis with arthritic symptoms than those of patients without arthritis, while PLR was increased (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of neutrophil count and NLR level for acute Brucellosis was 0.780 and 0.717, respectively, while the area under the ROC curve of CD3+T cell count for chronic Brucellosis was 0.748. In acute stage patients, the area under ROC curve of CD3+T, CD8+T cell count and PLR level for the diagnosis of arthritis was 0.779, 0.768 and 0.722, respectively. Conclusion The indexes of WBC and platelet of peripheral blood in patients with acute and chronic human Brucellosis are changed abnormally, which has a certain reference value in diagnosis of human Brucellosis and arthritis in acute Brucellosis patients.

Key words: Brucellosis, leukocyte count, platelet count, arthritis, area under curve

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