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目的探讨用流式细胞术检测再生障碍性贫血(aplastic anemia,AA)患者外周血中性粒细胞膜碱性磷酸酶(m NAP)变化的临床意义。方法病例对照研究。收集2014年8月至2015年12月连云港市第一人民医院收治的初诊全血细胞减少患者198例,其中明确诊断为AA者52例,对照组为非AA导致的全血细胞减少患者146例和体检健康者100例,用流式细胞术检测m NAP,ROC曲线评价其对AA的诊断效能。结果 AA、非AA疾病对照组及健康人对照组m NAP检测结果[M(P25~P75)]分别为13 931(11 128,21 605)、1 875(1 119,3 119)、1 831(1 371,2 411)AB/c,AA组m NAP表达水平明显高于非AA疾病对照组及健康人对照组,差异有统计学意义(P<0.01),而非AA组与健康人对照组比较差异无统计学意义(P>0.05)。m NAP诊断AA的ROC曲线下面积为0.95,在最佳切点为6 388AB/c时,诊断AA的敏感性为90.90%(95%CI 0.83~0.96),特异性为96.10%(95%CI 0.86~0.99)。结论检测外周血m NAP值对AA的鉴别诊断可能具有重要的辅助价值。
Objective To investigate the clinical significance of using flow cytometry to detect the change of neutrophil membrane alkaline phosphatase (m NAP) in patients with aplastic anemia (AA). Methods Case-control study. A total of 198 cases of newly diagnosed pancytopenia were collected from Lianyungang First People’s Hospital from August 2014 to December 2015. Among them, 52 cases were diagnosed as AA. The control group included 146 cases of non-AA-induced pancytopenia and physical examination 100 cases of healthy persons, m NAP was detected by flow cytometry, ROC curve evaluation of its diagnostic efficacy of AA. Results The results of m NAP in AA, non-AA control group and healthy control group were 13 931 (11 128, 21 605), 1875 (119 119, 119), 1831 1 371, 2 411). The level of m NAP expression in AB / c, AA group was significantly higher than that in non-AA control group and healthy control group (P <0.01), but not in AA group and healthy control group The difference was not statistically significant (P> 0.05). The area under the ROC curve for AA diagnosed by m NAP was 0.95 and the sensitivity for diagnosis of AA was 90.90% (95% CI 0.83-0.96) with a specificity of 96.10% (95% CI 0.86 ~ 0.99). Conclusion The detection of peripheral blood m NAP value of AA differential diagnosis may have important auxiliary value.