Study on variation of peripheral blood routine scattergram parameters in patients with hepatitis C
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摘要: 目的 探讨血常规散点图Lymph-Y、Lymph-X、Neut-Y、Neut-X等参数对丙型肝炎(HCV)患者临床诊断的意义。方法 选取2020年10月至2021年6月HCV患者366例作为观察组，并根据HCV-RNA Copy中位数进一步将HCV组分为HCV-Low组和HCV-High组；随机选取183例门诊患者作为健康对照组，研究HCV-RNA含量与血常规散点图参数和肝功能指标参数的相关性。结果 观察组与对照组间性别、年龄、中性粒细胞百分比(Neu%)、淋巴细胞百分比(Lym%)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)等指标比较，差异无统计学意义(P>0.05)；而血小板计数(PLT)、总胆红素(TBIL)、直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)比较，差异有统计学意义(P< 0.05)。相关性分析发现TBIL、DBIL、ALT、AST、GGT、ALP、Lymph-X与患HCV呈正相关，而Neu-SFL、PLT呈负相关。结论 HCV患者外周血常规参数PLT、Neu%、Lym%、Lymph-Y，Lymph-X、Neut-X、Neut-Y及肝功能指标ALT、AST会随着HCV-RNA含量的高低变化而变化，淋巴细胞散点图参数Lymph-X对HCV的诊断有意义。Abstract: Objective To explore the clinical diagnosis and prognosis of blood routine scatter plots Lymph-Y, Lymph-X, Neut-Y, Neut-X and other parameters for patients with hepatitis C, in addition to routine biochemical indicators.Methods A total of 366 patients with hepatitis C in the Second Affiliated Hospital of Xi'an Jiaotong University from January 2020 to April 2021 were selected as the observation group, and patients in the HCV group were further divided into HCV-Low group and HCV-High group according to the median of HCV-RNA Copy. At the same time, a total of 193 cases were randomly selected from outpatients as healthy controls. The hematological indexes of each group were statistically analyzed using SPSS 25.0 statistics, and the changes of HCV-RNA content and blood routine scatter plot parameters and liver function index parameters were studied.Results There was no significant difference in gender, age, percentage of neutrophils(Neu%), percentage of lymphocytes(Lym%), glutamyl transpeptidase(GGT) and alkaline phosphatase(ALP) between the observation group and the control group(P>0.05), while there was significant difference in platelet(PLT), total bilirubin(TB), direct bilirubin(DB), alanine aminotransferase(ALT) and aspartate amino transferase(AST) between the two groups (P< 0.05). Spearman correlation analysis showed that the parameters of TB, DB, ALT, AST, GGT, ALP, Lymph-X were positively correlated with hepatitis C infection, but PLT and Neu-SFL were negatively correlated.Conclusion Peripheral blood parameters PLT, Neu%, Lym%, Lymph-Y, Lymph-X, Neut-X, Neut-Y and liver function indexes ALT and AST of hepatitis C patients could change with the level of HCV-RNA content. Lymph-X, the parameter of lymphocyte scatter plot, might be of significance for the diagnosis of hepatitis C.
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Key words:
- hepatitis C /
- blood routine /
- lymphocyte /
- scatter plot sensitivity
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表 1 组间基本资料比较
X ±S 项目 对照组(193例) HCV-Low组(183例) HCV-High组(183例) F/χ2 P 女性/例(%) 99(51.73) 78(42.42) 68(36.36) 5.066 0.079 年龄/岁 53.44±15.04 55.52±14.48 52.33±11.94 0.435 0.648 Neu% 58.45±6.02 61.71±14.02 61.36±9.86 1.643 0.198 Lym% 32.43±5.95 28.37±12.68 30.63±12.27 1.868 0.159 PLT/(×109·L-1) 215.65±43.34 176.52±129.03 166.85±72.79 4.913 0.009 TBIL/(μmol·L-1) 14.20±7.36 21.48±22.97 18.55±11.94 3.115 0.048 DBIL/(μmol·L-1) 3.44±2.85 7.40±12.03 5.65±6.04 3.564 0.031 ALT/(U·L-1) 20.32±9.41 53.30±77.47 72.85±72.89 11.182 < 0.001 AST/(U·L-1) 21.10±6.16 54.48±49.72 64.15±45.88 20.275 < 0.001 GGT/(U·L-1) 35.24±62.20 51.15±50.89 81.94±151.44 2.816 0.064 ALP/(U·L-1) 83.06±55.09 98.67±32.38 88.00±36.86 1.253 0.289 
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表 2 Spearman相关性分析
项目 r P 性别 -0.196 0.026 年龄 -0.029 0.742 Neu% 0.158 0.074 Lym% -0.163 0.064 PLT -0.379 < 0.001 TBIL 0.242 < 0.001 DBIL 0.315 < 0.001 ALT 0.468 < 0.001 AST 0.699 < 0.001 GGT 0.225 0.010 ALP 0.183 0.038 Neut-X -0.129 0.146 Neut-Y -0.210 0.017 Lymph-X 0.408 < 0.001 Lymph-Y -0.115 0.194
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表 3 二元logistic回归分析
项目 B SE Wald χ2 P OR 95%CI AST 0.265 0.061 1.112 < 0.001 1.303 1.157~1.467 Lymph-X 0.557 0.204 7.496 0.006 1.746 1.172~2.602 常量 -51.752 16.965 9.306 0.002
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