目的 探讨肺癌患者血小板(PLT)参数与其临床病理特征的相关性.方法 回顾性分析136例肺癌患者(肺癌组)PLT参数,包括PLT计数、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW).以同期117名健康体检者作为对照组.评价PLT参数与病理组织类型、TNM临床分期、是否存在淋巴结转移的关系.结果 肺癌组患者PLT计数、PCT和MPV均显著高于对照组;高PLT计数(≥237.6×109/L)和高PCT(≥0.25％)与肺癌患者TNM分期有关(P<0.05),高MPV(≥12.41 fL)与肺癌患者存在淋巴结转移有关(P<0.05);不同TNM分期肺癌患者间PLT计数、PCT有显著差异(P<0.01),存在淋巴结转移时PLT计数、PCT、MPV均升高(P<0.05).结论 PLT参数升高与肺癌患者临床病理特征密切相关,PLT参数在肺癌发生、发展及转移中起重要作用.

Objective To observe the clinical characteristics of bacterial pneumonia children,and the changes of the serum levels of white blood cells(WBC),C-reactive protein(CRP) and procalcitonin(PCT) before and after anti-bacterial therapy,and to explore the predictive value in early diagnosis and therapy.Methods 130 bacterial pneumonia children were enrolled prospectively as pneumonia group.The clinical data were collected and the serum CRP,PCT and WBC were detected before anti-bacterial therapy (within 24h after admission) and after anti-bacterial therapy (the seventh day after admission).34 healthy children were enrolled as control group.The general clinical characteristics of the children in the pneumonia group were observed.The levels of serum CRP,PCT and WBC between the pneumonia group and the control group were compared.The levels of serum CRP,PCT and WBC before and after anti-bacterial therapy in the bacterial pneumonia children were compared.The clinical value of PCT,CRP and WBC in early predicting bacterial pneumonia was identified.Results Compared with the control group,the sex and age of the bacterial pneumonia children demonstrated no statistically significant differences (t =1.012,P =0.395;x2 =0.003,P =0.959).The mean course of the disease before admission was (5.34 ± 1.27) d,with mean temperature of (38.27 ± 0.96) ℃,and hospital days of (8.92 ± 3.93) d.35 cases were cured,and 95 cases were improved,with no death.The serum levels of CRP,PCT and WBC in pneumonia children on admission were (12.24 ±6.35) mg/L,(0.18 ± 0.15) ng/mL and (14.25 ± 7.59) 109/L,respectively,which were higher than those of the control group,the differences were statistically significant (t =4.650,5.867,2.548,all P ＜ 0.05).The serum levels of CRP,PCT and WBC in pneumonia children before anti-bacterial therapy were higher than after bacterial therapy,showed statistically significant differences(t =8.165,7.232,5.112,all P ＜ 0.05).The area under the curve (AUC)of the PCT,CRP and WBC in early predicting bacterial pneumonia were 0.928,0.834 and 0.718 respectively by the relative operating characteristic (ROC) curve analysis (P ＜ 0.05).The sensitivity and specificity of PCT in predicting bacterial pneumonia were higher than CRP and WBC.Conclusion The statistics efficacy of PCT in early predicting children bacterial infection was obviously higher than CRP and PCT.The combined detection of CRP,PCT and WBC was benefit to improve the diagnostic sensitivity and specificity of children with bacterial pneumonia.

糖尿病(diabetes mellitus,DM)一词是描述一种多病因的代谢疾病,特点是慢性高血糖,伴随因胰岛素(INS)分泌及/或作用缺陷引起的糖、脂肪和蛋白质代谢紊乱[1].目前,临床治疗糖尿病常用指标主要测定空腹血糖和尿糖及餐后2 h血糖.