异型淋巴细胞、VCS和SAA检测在传染性单核细胞增多症并发肝功能损害中的早期诊断价值

目的探讨血清淀粉样蛋白A(SAA)、白细胞VCS参数及异型淋巴细胞比例等检测在传染性单核细胞增多症(IM)并发肝功能损害中的早期诊断价值。方法选取100例IM患儿作为实验组、30例IM并发肝功能损害患儿作为肝损害组,同时选取50名体检健康儿童作为对照组。分别检测患儿急性期和恢复期SAA水平,并对患儿进行外周血细胞形态学检查,比较各组VCS之间差异,对检测结果进行分析比较。结果实验组和肝损害组急性期SAA水平分别为(147.25±36.51)mg/L和(225.11±48.38)mg/L,明显高于对照组SAA水平(0.59±0.12)mg/L,差异有统计学意义(P<0.05),恢复期SAA水平分别为(15.81±8.16)mg/L和(21.48±11.13)mg/L,显著高于对照组SAA水平(0.59±0.12)mg/L,差异有统计学意义(P<0.05),在急性期和恢复期肝损害组SAA水平均显著高于实验组,差异有统计学意义(P<0.05)。肝损害组异型淋巴细胞比例大于10%占66.7%,实验组异型淋巴细胞比例大于10%占38.0%,差异有统计学意义(P<0.05);镜下观察肝损害组凋亡淋巴细胞比例高于实验组;实验组和肝损害组淋巴细胞和单核细胞体积高于对照组,差异有统计学意义(P<0.05)。结论异型淋巴细胞、白细胞VCS参数及SAA水平对IM并发肝功能损害患儿早期诊断、疾病的严重程度、治疗效果、早期恢复和疾病预后效果显著,具有重要的临床意义。

The early diagnosis value of heteromorphic lymphocyte,VCS and SAA in infectious mononucleosis with liver function damage

Objective To investigate the value of serum amyloid A(SAA),positional parameters of leucocytes such as volume,conductivity and scatter(VCS)and proportion of atypical lymphocytes in the early diagnosis of liver function damage caused by infectious mononucleosis(IM).Methods A total of 100 cases of IM were selected as experimental group,30 cases of IM complicated with liver function impairment as liver damage group,Totally,50 healthy subjects were enrolled as control group.The levels of SAA in the acute and convalescent stages were determined.Morphological examination of peripheral blood cells was performed and compared the VCS differences in each group,then the test results were analyzed and compared.Results The acute stage levels of SAA were(147.25±36.51)mg/L and(225.11±48.38)mg/L in experimental group and liver damage group,which were significantly higher than the level of the control group(0.59±0.12)mg/L,the difference was statistically significant(P<0.05),Meanwhile,the convalescence levels of SAA were(15.81±8.16)mg/L and(21.48±11.13)mg/L in experimental group and liver damage group were significantly increased than those in the control group(0.59±0.12)mg/L,the difference was statistically significant(P<0.05).SAA expression levels in both acute and convalescent of liver damage group were significantly higher than those in the experimental group(P<0.05).The proportion of abnormal lymphocytes in the liver damage group was more than 10%,accounting for 66.7%,and that in the experimental group was more than 10%,accounting for 38.0%,the difference was statistically significant(P<0.05).Under the microscope,the proportion of apoptotic lymphocytes in the liver damage group was higher than that in the experimental group.The volume of lymphocytes and monocytes in the experimental group and liver damage group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Atypical lymphocytes,leukocyte VCS parameters and SAA expression level have significant clinical significance in the early diagnosis,severe course of the diseases,treatment effect,early recovery and prognosis of children with liver function damage complicated by infectious mononucleosis.