文章摘要
李 欢,顾炳权,刘昕阳,苏海鹏,董 轲.AD-MPE与TPE患者血常规参数变化及其诊断价值[J].,2021,(3):471-475
AD-MPE与TPE患者血常规参数变化及其诊断价值
The Predictive Value of Initial Diagnosis and Changes of Blood Routine Parameters in Patients with AD-MPE and TPE
投稿时间:2020-04-28  修订日期:2020-05-23
DOI:10.13241/j.cnki.pmb.2021.03.014
中文关键词: 胸腔积液  血常规参数  血小板/淋巴细胞比值  肺腺癌  联合诊断
英文关键词: Pleural effusion  Blood routine parameters  Platelet-lymphocyte ratio (PLR)  Lung adenocarcinoma  Joint diagnosis
基金项目:国家自然科学基金面上项目(81572974)
作者单位E-mail
李 欢 解放军空军军医大学第二附属医院检验科 陕西 西安 710038 huanliarticle@163.com 
顾炳权 解放军空军军医大学第二附属医院检验科 陕西 西安 710038  
刘昕阳 解放军空军军医大学第二附属医院检验科 陕西 西安 710038  
苏海鹏 解放军空军军医大学第二附属医院检验科 陕西 西安 710038  
董 轲 解放军空军军医大学第二附属医院检验科 陕西 西安 710038  
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中文摘要:
      摘要 目的:比较结核性胸腔积液(tuberculous pleural effusion, TPE)和肺腺癌性胸腔积液(malignant pleural effusion associated with lung adenocarcinoma, AD-MPE)血常规参数及相关炎症指标的比值,探讨单项指标或联合分析的鉴别诊断价值。方法:对临床确诊的100例AD-MPE患者和84例TPE患者的血常规参数进行分析,比较各指标在两组疾病中的差异,并用ROC曲线分析以确定单项指标以及联合分析的鉴别诊断性能。结果:AD-MPE组的白细胞数(WBC)、中性粒细胞绝对值(NEUT)、淋巴细胞数(LYMPH)、淋巴细胞/单核细胞比值(LMR)、平均血小板体积(MPV)、大血小板比率(P-LCR)和血小板分布宽度(PDW)水平高于TPE组(P<0.05),TPE组的单核细胞百分比(MONO%)、血小板/淋巴细胞比值(PLR)、血小板数(PLT)和血小板比积(PCT)水平均高于AD-MPE组(P<0.05);ROC曲线分析显示WBC、MONO%和PLR相比较其它单项指标,具有较好的鉴别诊断价值(AUC>0.7)并且三者联合有最高的鉴别诊断价值(Youden Index>0.5,AUC>0.7)。结论:AD-MPE和TPE在炎症反应和凝血功能方面有不同程度的变化,血常规参数分析对TPE和AD-MPE中具有一定的鉴别诊断价值,尤其是WBC、MONO%和PLR的联合分析。
英文摘要:
      ABSTRACT Objective: To compare the of blood routine parameters and ratio of related indicators in tuberculous pleural effusion (tuberculous pleural effusion, TPE) and malignant pleural effusion associated with lung adenocarcinoma (malignant pleural effusion associated with lung adenocarcinoma, AD-MPE) and explore the value of single indicators or joint analysis in the initial identification of AD-MPE and TPE. Methods: The blood routine parameters of 100 clinically confirmed AD-MPE patients and 84 TPE patients were analyzed, and the differences of indicators between the two groups were compared. The ROC curve analysis was used to determine the differential diagnostic performance of single indicators and combined analysis. Results: The level of WBC, NEUT, LYMPH, LMR, MPV, P-LCR and PDW in the AD-MPE was significantly higher than that of TPE group (P<0.05); The level of MONO%, PLR, PLT and PCT in the TPE was significantly higher than that of AD-MPE group (P<0.05); ROC curves showed that WBC, MONO% and PLR had better differential diagnosis value (AUC > 0.7) compared with other single indicators, and the combination of the three had the highest differential diagnosis value (Youden Index > 0.5, AUC > 0.7). Conclusion: There are varying degrees of changes in the inflammatory response and coagulation function of AD-MPE and TPE, and this changes may have their own characteristic patterns; As a routine clinical test, the analysis of blood routine parameters has certain differential diagnostic value in the preliminary differential diagnosis of TPE and AD-MPE, especially the combined analysis of WBC, MONO% and PLR.
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