血常规指标在广西地区筛查华支睾吸虫病中的应用价值研究

摘要

目的:探讨白细胞计数(WBC)、中性粒细胞计数(NEU)、嗜酸性粒细胞计数(EOS)、血小板计数(PLT)、血红蛋白浓度(HB)和红细胞分布宽度(RDW)等血常规指标在华支睾吸虫病筛查中的应用价值.方法:选取2017年1月至2017年12月在广西医科大学第一附属医院治疗的54例无临床症状的华支睾吸虫病患者为感染组,血清肝吸虫抗体为阴性的54例健康体检者为对照组,比较两组WBC、NEU、EOS、PLT、HB和RDW,采用Logistic回归分析,建立华支睾吸虫病新诊断模型,受试者工作特征(ROC)曲线分析血常规各指标及基于血常规指标的新回归模型诊断效果.结果:感染组WBC、EOS均明显高于对照组,HB明显低于对照组,差异均有统计学意义(P＜0.05).两组PLT、NEU和RDW比较差异均无统计学意义(P＞0.05).经Logistic回归分析得出新诊断模型:logit P=0.835×NEU+7.271×EOS-0.017×PLT-0.08×HB-52.12×RDW+17.773.新回归模型logistic P诊断华支睾吸虫病的曲线下面积(AUC=0.854)明显高于WBC(AUC=0.622),EOS(AUC=0.705)和HB(AUC=0.369),差异均有统计学意义(P＞0.05).结论:联合应用血常规指标有助于提高肝吸虫病的诊断效能,WBC、NEU、EOS、PLT、HB和RDW在华支睾吸虫病的筛查中具有重要的临床意义,可用于流行区人群肝吸虫病筛查.%Objective:To investigate the value of white blood cell counts (WBC),neutrophil counts (NEU),eosinophil counts (EOS),blood platelet counts (PLT),hemoglobin (HB) and red blood cell distribution width (RDW) in clonorchiasis screening.Methods:We selected a total of 54 asymptomatic patients with clonorchiasis (study group) and 54 healthy subjects (control group) with negative Clonorchis sinensis antibody from January 2017 to December 2017 in our hospital.WBC,NEU,EOS,PLT,HB and RDW were compared between the two groups.Then we established a new diagnostic model by logistic regression.Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of blood parameters and the new model.Results:WBC and EOS in the study group were significantly higher than those in the control group (P＜0.05),while the HB level was markedly lower (P＜0.05).No significant differences were found in PLT,NEU and RDW between the two groups (P＞0.05).According to the results of logistic regression,we established a new model:logit P =0.835 × NEU+ 7.271 × EOS-0.017 × PLT-0.08 × HB -52.12 × RDW+17.773.The AUC of WBC,EOS,HB and the new model were respectively 0.622,0.705,0.369 and 0.854.The AUC of the new model was significantly higher than that of WBC,EOS and HB (P＞0.05).Conclusion:The combination of blood parameters for clonorchiasis screening could improve the diagnostic efficiency.WBC,NEU,EOS,PLT,H B and RDW might serve as the screening indexes in patients infected with Clonorchis sinensis in the endemic areas of clonorchiasis.