摘要
目的探讨新型冠状病毒肺炎(COVID-19)患者外周血中T淋巴细胞亚群的表达及外周血白细胞水平的临床应用价值。方法选取2020年2月3日至2月29日首都医科大学附属北京地坛医院收治的46例COVID-19确诊患者作为研究对象,并按疾病严重程度分为普通组和重症组。用SPSS 17.0统计学软件回顾性分析比较两组患者中性粒细胞(N)、淋巴细胞(L)、NLR(N/L)、CD4^+、CD8^+、CD4^+/CD8^+、N4R(N/CD4^+)和N8R(N/CD8^+)指标的表达水平,并采用受试者工作曲线(ROC)评价以上不同指标在普通型和重症型COVID-19患者间的诊断价值。结果本研究共收集46例新冠肺炎患者,其中重症组18例(男女比例:11/7),普通组28例(男女比例:15/13),平均年龄分别是69.5岁和34岁(P<0.001)。重症组中的中性粒细胞计数(N)、NLR(N/L)、CD4^+/CD8^+、N4R(N/CD4^+)和N8R(N/CD8^+)都显著高于普通组(5.36×109 vs 2.92×109;6.40 vs 1.71;1.87 vs 1.31;0.017 vs 0.005;0.029 vs 0.004),重症组中的淋巴细胞计数(L)、CD4^+和CD8^+都显著低于普通组(0.85×109 vs 1.60×109;328 vs 496;151 vs 433)。上述差异均有统计学意义(P<0.05)。ROC曲线分析各个指标对COVID-19患者的诊断价值结果显示:CD8^+诊断COVID-19患者的ROC曲线下面积是0.849,特异性和灵敏度分别71.43%和83.88%;N/CD8诊断COVID-19患者的ROC曲线下面积是0.875,特异性和灵敏度分别是71.43%和100%;淋巴细胞诊断COVID-19患者的ROC曲线下面积是0.865,特异性和灵敏度分别是60.71%和100%。结论CD8^+、N/CD8^+和淋巴细胞计数(L)三者在区分COVID-19重症型和普通型上有较好的灵敏度和特异性,可以提高临床对二者的鉴别能力。
Objective To investigate the expression of T lymphocyte subsets in peripheral blood of patients with new coronavirus pneumonia(COVID-19)and the clinical value of peripheral blood leukocyte levels.Methods 46 patients diagnosed with COVID-19 admitted to Beijing Ditan Hospital Affiliated to Capital Medical University from February,3rd to February 29th,2020,were selected as the research subjects and were divided into the mild group and severe group according to the severity of the disease.SPSS17.0 statistical software was used to retrospectively analyze the neutrophils(N),lymphocytes(L),neutrophils lymphocytes ratio(N/L),CD4^+,CD8^+,CD4^+/CD8^+,neutrophils CD4^+ratio(N/CD4^+),neutrophils CD8^+ratio(N/CD8^+)of the two groups of patients.The receiver operating curve(ROC)was applied to evaluate the diagnostic value of the above different signs in patients with mild or severe COVID-19.Results A total of 46 COVID-19 patients were collected in this study,including 18 cases in the severe group(male to female ratio:11/7)and 28 cases in the mild group(male to female ratio:15/13)with average ages of 69.5 and 34 years old(P<0.001),respectively.The neutrophil count(N),neutrophils lymphocytes ratio(N/L),CD4^+/CD8^+,neutrophils CD4^+ratio(N/CD4^+)and neutrophils CD8^+ratio(N/CD8^+)in the severe group were significantly higher than those of the mild group(5.36×109 vs 2.92×109;6.40 vs 1.71;1.87 vs 1.31;0.017 vs 0.005;0.029 vs 0.004).The lymphocyte count(L),CD4^+,and CD8^+in the severe group were significantly lower than those of the mild group(0.85×109 vs 1.60×109;328 vs 496;151 vs 433).The above differences were statistically significant(P<0.05).The diagnostic value based on ROC curve analysis for COVID-19 patients showed that the area under the curve of CD8^+was 0.849,with specificity and sensitivity of 71.43%and 83.88%,respectively.The area under the curve of neutrophils CD8^+ratio(N/CD8^+)was 0.875,with the specificity and sensitivity of 71.43%and 100%,respectively.The area under the curve of lymphocyte diagnosis was 0.865,w
作者
杨晓玲
徐新民
宋淑静
周茹
李娟
王雅杰
YANG Xiaoling;XU Xinmin;SONG Shujing;ZHOU Ru;LI Juan;WANG Yajie(Department of Laboratory Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)
出处
《标记免疫分析与临床》
CAS
2020年第10期1659-1662,共4页
Labeled Immunoassays and Clinical Medicine
基金
新发突发传染病研究北京市重点实验室(编号:DTKF201801)。
