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目的探讨外周血嗜酸性粒细胞在肝移植术后急性排斥反应中的临床诊断价值。方法回顾性分析中山大学附属第三医院肝移植术后患者的临床资料,根据病理确诊结果将肝移植术后患者分为急性排斥组(28例)和非排斥组(72例),随机抽取40例健康查体者为对照组,测定各组人员的外周血嗜酸性粒细胞的绝对值和百分比。根据受试者工作曲线(ROC)确定嗜酸性粒细胞绝对值和比例的临界值,分析其诊断急性排斥反应的敏感度和特异度。结果急性排斥组、非排斥组、对照组外周血嗜酸性粒细胞阳性率分别为100.00%、11.11%、0.00%,急性排斥组与其他2组比较,差异均有统计学意义(P<0.05)。ROC曲线分析显示,外周血嗜酸性粒细胞绝对值用于诊断肝移植术后急性排斥的临界值为0.295×109/L时,AUC为0.940;嗜酸性粒细胞百分比临界值为8.75%时,AUC为0.978。结论外周血嗜酸性粒细胞可作为肝移植术后患者急性排斥反应的实验室诊断指标。
Objective To investigate the clinical value of peripheral blood eosinophils in acute rejection after liver transplantation. Methods The clinical data of patients after liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. According to the results of pathological diagnosis, the patients after liver transplantation were divided into acute rejection group (n = 28) and non-rejection group (n = 72) Cases of health examination were control group, the determination of the absolute value of the group of patients with eosinophils and the percentage of the percentage. According to the receiver operating curve (ROC) to determine the absolute value of eosinophils and the ratio of the critical value, analysis of its sensitivity and specificity of diagnosis of acute rejection. Results The positive rates of eosinophils in acute rejection group, non-rejection group and control group were 100.00%, 11.11% and 0.00% respectively. There was significant difference between acute rejection group and other two groups (P <0.05) . ROC curve analysis showed that the absolute value of peripheral blood eosinophils for the diagnosis of acute rejection after liver transplantation was 0.295 × 109 / L, the AUC was 0.940; the eosinophil percentage of the critical value of 8.75%, AUC Is 0.978. Conclusion Peripheral blood eosinophils can be used as laboratory diagnostic indicators of acute rejection in patients after liver transplantation.