淋巴细胞VCS参数辅助诊断活动性肺结核的临床应用研究

目的研究通过DxH800血细胞分析仪的VCS技术分析淋巴细胞在活动性肺结核中的形态学变化,评价其在辅助诊断活动性肺结核中的价值。方法收集重庆地区活动性肺结核患者97例,潜伏性结核113例和体检健康者101例(健康对照组),采用DxH800血细胞分析仪对淋巴细胞VCS参数进行检测,并对各参数的受试者工作特征曲线(ROC曲线)的曲线下面积进行分析。结果淋巴细胞平均体积(MLV)及其标准差(MLV-SD)、淋巴细胞平均导电率标准差(MLC-SD)、中角度光散色标准差(MALS-SD)、高中角度光散色标准差(UMALS-SD)、低中角度光散色标准差(LMALS-SD)、低角度光散射(LALS)及其标准差(LALS-SD)、轴向光损耗测量标准差(AL2-SD)在活动性肺结核组显著高于潜伏性结核组和健康对照组(P<0.05);活动性肺结核组的MALS、LMALS明显低于潜伏性结核组和健康对照组(P<0.05)。ROC曲线分析显示,MLV-SD、MLC-SD、UMALS-SD、LALS-SD、AL2-SD曲线下面积分别为0.775、0.900、0.802、0.860、0.785,同时测量这5个参数获得曲线下面积高达0.920,其灵敏度为79.40%,特异度为92.90%。结论淋巴细胞VCS多个参数可辅助诊断活动性肺结核,且检测方便易行,可为临床诊断活动性肺结核提供帮助。

Clinical application of lymphocyte VCS parameters in identifying active pulmonary tuberculosis

Objective To study the morphological changes of lymphocytes in active tuberculosis by VCS of DxH800 blood cell analyzer,and to evaluate its value in the auxiliary diagnosis of active pulmonary tuberculosis.Methods A total of 97 cases of active tuberculosis,113 cases of latent tuberculosis and 101 cases of physical examination(healthy control group)were collected in Chongqing.The VCS parameters of lymphocytes were measured by DxH800 hematology analyzer,and the area under the ROC curve was analyzed.Results Lymphocyte mean volume(MLV)with its standard deviation(MLV-SD),lymphocyte mean conductivity standard deviation(MLC-SD),medium angle light scatter standard deviation(MALS-SD),upper median angle light scatter standard deviation(UMALS-SD),lower median angle light scatter standard deviation(LMALS-SD),low angle light scatter(LALS)with its standard deviation(LALS-SD),axial light loss measurement standard deviation(AL2-SD)in active tuberculosis group were significantly higher than the latent tuberculosis and the healthy controls(P<0.05).The medium angle light scatter(MALS)and lower median angle light scatter(LMALS)in active tuberculosis group were significantly lower than that of the latent tuberculosis group and the healthy controls(P<0.05).The area under the ROC curve showed that the areas under MLV-SD,MLC-SD,UMALS-SD,LALS-SD,and AL2-SD curves were 0.775,0.900,0.802,0.860 and 0.785,respectively.At the same time,the areas under the curves were as high as 0.920,with a sensitivity of 79.40%and a specificity of 92.90%.Conclusion Multiple parameters of lymphocyte VCS can assist in the diagnosis of active tuberculosis,and the detection is convenient and easy,which can help the clinical diagnosis of active tuberculosis.