早期带状疱疹、急性胆囊炎、急性心肌梗死患者血细胞计数检测结果比较的临床分析

摘要

Objective To evaluate the diagnostic value of these alternant indexes by compare the results of routine blood test of early herpes zoster(HZ),acute cholecystitis and acute myocardial infarction patients.Methods According to some inclu-sion and exclusion criteria,78 HZ patients,59 acute cholecystitis and 51 acute myocardial infarction patients from October 2013 to March 2017 were included.The receiver operator characteristics(ROC)were used to evaluate the diagnostic value of the blood corpuscle indexes.Results White blood cell count(WBC),blood platelet count(PLT)and neutrophilic granulo-cyte percentage(NE%)of HZ patients were lower than the acute cholecystitis and acute myocardial infarction patients(P<0.001).Lymphocyte percentage(LYM%)and monocyte percentage(MO%)were higher than the others'.The NE% index had a certain diagnostic value(AUC=0.848,95%CI:0.792~0.905).There was a highest specificity in LYM% index(spe-cificity=0.963).Conclusion There were some clinical significance of routine blood cell count results on the early HZ diag-nosis,which can reduce the missed diagnosis and misdiagnosis rate of an early diagnosis herpes zoster.%目的 比较早期带状疱疹、急性胆囊炎和急性心肌梗死患者入院时血细胞计数检测结果的不同,分析不同指标变化在三种疾病鉴别诊断中的价值.方法 按一定的纳入排除标准,选取2013年10月~2017年3月于西安交通大学第一附属医院确诊的带状疱疹患者78例、急性胆囊炎患者59例、急性心肌梗死患者51例,比较其入院血常规检查各指标的结果,分析其受试者工作特征(ROC)曲线,寻找各指标的最佳截断值.结果 早期带状疱疹患者的白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞百分比(NE%)三个指标均低于急性胆囊炎和急性心肌梗死患者(P<0.05);淋巴细胞百分比(LYM%)和单核细胞百分比(MO%)指标均高于急性胆囊炎和急性心肌梗死患者(P<0.05).其中做鉴别诊断价值最高的是 NE%指标(AUC=0.848,95%CI:0.792~0.905);特异度最高的指标是 LYM%,在最佳截断值19.21%处,特异度可达0.963.结论 血细胞计数检查结果对早期带状疱疹的鉴别诊断具有一定的意义,可降低早期带状疱疹诊断的漏诊率和误诊率.