摘要
目的研究血小板/淋巴细胞比值(PLR)及外周血小板相关参数对疟疾早期感染的临床价值。方法收集2021年1-4月马里共和国43例疟疾患者(疟疾组)和43名健康者(健康对照组),进行血常规和外周血涂片等项目的检测,比较两组淋巴细胞绝对值(LYM)、血小板(PLT)、PLR、血小板分布宽度(PDW)、平均血小板体积(MPV)水平,采用多因素logistic回归分析发生疟疾的危险因素,同时采用受试者工作特征曲线(ROC)评估PLR、PDW对疟疾的预测价值。结果疟疾组PLR、PLT水平[(64.69±4.73)、(181.70±9.90)×10^(9)/L]明显低于健康对照组[(134.50±13.03)、(285.50±11.87)×10^(9)/L],差异均有统计学意义(t=5.033、36.716,P均<0.001);而PDW、MPV水平[(13.55±0.35)、(11.12±0.19)fL]高于健康对照组[(12.32±0.31)、(10.55±0.16)fL],差异均有统计学意义(t=2.632、2.289,P均<0.05)。PLR降低(OR=0.949,95%CI:0.949~0.984)、PDW增高(OR=1.362,95%CI:1.048~1.771)是疟疾发生的独立危险因素。ROC曲线分析结果显示,PLR、PDW预测疟疾的曲线下面积(AUC)分别为0.828、0.657,二者联合预测时AUC为0.852,其诊断效能比单一指标高。结论PLR的降低及PDW和MPV的增加对于判断早期疟疾感染有一定的临床价值,有利于在疟疾流行且医疗条件不发达的地区进行疟疾的初筛。
Objective To study the clinical value of platelet lymphocyte rate(PLR)and related parameters of peripheral blood platelets in early malaria infection.Methods From January to April 2021,43 malaria patients(malaria group)and 43 healthy patients(healthy control group)in the Republic of Mali were collected,and blood routine and peripheral blood smear tests were performed.The lymphocyte absolute value(LYM),platelet(PLT),PLR,platelet distribution width(PDW)and mean platelet volume(MPV)were compared between the two groups,and the risk factors of malaria were determined by multivariate logistic regression analysis.The predictive value of PLR and PDW for malaria was evaluated by receiver operating characteristic(ROC)curve.Results The levels of PLR and PLT in the malaria group[(64.69±4.73),(181.70±9.90)×10^(9)/L]were significantly lower than those in the healthy control group[(134.50±13.03),(285.50±11.87)×10^(9)/L],the differences were statistically significant(t=5.033,36.716;both P<0.001);while the levels of PDW and MPV[(13.55±0.35),(11.12±0.19)fL]were significantly higher than those in the healthy control group[(12.32±0.31),(10.55±0.16)fL],the differences were statistically significant(t=2.632,2.289;both P<0.05).Decreased PLR(OR=0.949,95%CI:0.949-0.984)and increased PDW(OR=1.362,95%CI:1.048-1.771)were independent risk factors for malaria.The area under curve(AUC)of PLR and PDW for predicting malaria were 0.828 and 0.657,respectively.The AUC of the combined prediction was 0.852 and the diagnostic efficiency was higher than that of the single index.Conclusion The decrease of PLR and the increase of PDW and MPV have certain clinical value for the diagnosis of early malaria infection,which is beneficial for the initial screening of malaria in the areas where malaria is prevalent and medical conditions are not developed.
作者
吴美慧
时小淋
刘登科
WU Meihui;SHI Xiaolin;LIU Dengke(The Second Hospital of Weihai,Qingdao University(Weihai Maternal and Child Health Hospital)Clinical Laboratory,Weihai,Shandong 264200,China;The 967th Hospital of the PLA Joint Logistic Support Force ICU,Dalian,Liaoning 116000,China)
出处
《热带医学杂志》
CAS
2024年第3期371-373,共3页
Journal of Tropical Medicine
