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目的 探讨中性粒细胞碱性磷酸酶 (alkalinephosphatase ,ALP)活性在传染性非典型肺炎 (严重急性呼吸综合征 ,SARS)患者诊断与鉴别诊断中的应用价值。方法 抽取 138例临床确诊的SARS患者、14 4例除外SARS的其他发热患者和 15 7名正常健康人 (男 80例 ,女 77例 )静脉血 ,制备血涂片。所有血涂片依改良Gomori氏法进行ALP细胞免疫组织化学染色 ,显微镜油镜观察 10 0个中性粒细胞 ,以阳性率和积分记录结果。结果 正常健康人群中性粒细胞碱性磷酸酶染色 (NAP)阳性率和积分中位数均为 10 0 0 ,差异无统计学意义 (P >0 0 5 ,P >0 0 5 ) ;非SARS发热患者组、SARS患者组中性粒细胞ALP阳性率 (中位数 )分别为 4 0 0 0、16 0 0 ,积分分别为 5 0 5 0、17 0 0 ,经统计学处理表明 ,不论NAP阳性率还是积分 ,非SARS发热患者高于SARS患者 ,SARS患者高于正常对照 (P<0 0 1)。结论 正常健康人群、非SARS发热患者、SARS患者间中性粒细胞碱性磷酸酶存在差异 ,将中性粒细胞碱性磷酸酶用于SARS的诊断与鉴别诊断有待进一步观察。
Objective To investigate the value of alkaline phosphatase (ALP) activity in the diagnosis and differential diagnosis of SARS (SARS) in patients with severe acute respiratory syndrome (SARS). Methods Blood samples were collected from 138 clinically diagnosed SARS patients, 14 4 other fever patients with SARS and 15 7 normal healthy subjects (80 males and 77 females). All blood smears were examined by modified Gomori’s method for ALP cell immunohistochemical staining. A total of 10 neutrophils were observed with a microscope and the positive rate and integral were recorded. Results The positive rate and integral median of neutrophil alkaline phosphatase (NAP) in healthy controls were both 100% In the febrile patients group, the positive rates of ALP in the neutrophils in the SARS patients group were respectively 40000 and 1600, with integrals of 500 and 700 respectively. The statistical analysis showed that no matter whether the NAP The positive rate was also positive. The patients with SARS fever were higher than those with SARS, and the patients with SARS were higher than the normal controls (P <0.01). Conclusion There are differences in neutrophilic alkaline phosphatase among normal healthy population, non-SARS fever patients and SARS patients. The use of neutrophil alkaline phosphatase in the diagnosis and differential diagnosis of SARS needs further observation.