朱婕琳

[摘要] 目的 分析老年急性肺栓塞患者外周血单核细胞、中性粒细胞、白细胞变化及其临床意义。 方法 选取我科2015年2月至2018年2月急性肺栓塞患者55例作为病例组;另选取同期在本院体检健康者 41例作为健康对照组。比较病例组治疗前及治疗7 d后与健康对照组外周血单核细胞（PBM）、中性粒细胞（PBN）、白细胞（PBL）变化。 结果 （1）病例组治疗前外周血白细胞计数、中性粒细胞计数、外周血单核细胞计数均高于治疗后，差异具有统计学意义（P<0.01）;（2）病例组治疗前与健康对照组受试者外周血白细胞计数、中性粒细胞计数、外周血单核细胞计数对比，差异具有统计学意义（P<0.01）;（3）病例组治疗后与健康对照组白细胞计数、中性粒细胞计数、外周血单核细胞计数比较，差异均无统计学意义（P>0.05）。 结论 外周血单核细胞、中性粒细胞、白细胞可以作为肺栓塞症的诊断指标之一，具有一定的临床意义，可作为老年急性肺栓塞诊断的参考依据。

[关键词] 急性肺栓塞;单核细胞;中性粒细胞;白细胞;临床意义;老年

[中图分类号] R563.5          [文献标识码] A          [文章编号] 1673-9701（2021）11-0010-03

Changes and clinical significance of peripheral blood monocytes， neutrophils and leukocytes in elderly patients with acute pulmonary embolism

ZHU Jielin

Department of Cadre Health Care， Zhongshan Hospital Xiamen University， Xiamen   361000， China

[Abstract] Objective To analyze the changes and clinical significance of peripheral blood monocytes， neutrophils and leukocytes in elderly patients with acute pulmonary embolism（APE）. Methods A total of 55 patients with APE from February 2015 to February 2018 in our department were selected as the case group. 41 healthy patients who were examined in our hospital at the same time were selected as the healthy control group. The changes of peripheral blood monocytes（PBM）， neutrophils（PBN） and leukocytes（PBL） in the case group were compared with those in the healthy control group before and 7 days after treatment. Results （1）PBL count， PBN count and PBM count in case group were all higher before treatment than those after treatment， and the differences were statistically significant（P<0.01）. （2）There were significant differences in PBL count， PBN count and PBM count between the case group and the healthy control group before treatment（P<0.01）. （3）After treatment， there were no statistical differences in PBL count， PBN count and PBM count between the case group and the healthy control group（P>0.05）. Conclusion PBM count， PBN count and PBL count can be used as diagnostic indexes of APE， which has certain clinical significance and can be used as a reference basis for the diagnosis of APE in old people.

[Key words] Acute pulmonary embolism; Monocyte; Neutrophil; Leukocyte; Clinical significance; Elderly

肺栓塞是由于栓子進入肺动脉及其分支，阻断组织血液供应，引起肺循环和右心功能障碍的一组疾病或临床综合征的总称。根据栓子来源和性质不同，可分为肺血栓栓塞、羊水栓塞、脂肪栓塞、空气栓塞、肿瘤栓塞及细菌性栓塞等，其中肺动脉血栓栓塞症 （Pulmonary thromboembolism，PTE）为肺栓塞最常见的类型，以肺循环和呼吸功能障碍为主要临床表现，是来自于静脉系统或右心的血栓阻塞肺动脉或其分支所导致的。由于其临床表现复杂，且症状缺乏特异性，所以临床容易误诊[1]，是临床死亡率较高的疾病之一[2-3]，是心血管疾病致死的常见原因之一[4]。因此临床及时而准确诊断肺血栓栓塞，同时对疾病的严重程度做出准确的评估和及时的治疗对患者至关重要。……