目的:观察血液病患者造血干细胞移植后外周血细胞参数的近期动态变化,了解骨髓恢复情况。方法:使用SE-9500血细胞分析仪对28例血液病患者造血干细胞移植前后血液进行检测,观察移植后一个月内各参数的变化。结果:28例外周血干细胞移植前后各细胞参数的观察发现,红细胞平均容积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)和红细胞体积发布宽度(RDW-CV%)等参数其结果在干细胞移植前后进行比较,虽然有变化,但无显著性差异(Pgt;0.05);红细胞计数(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、网织红细胞绝对数(RET)、低荧光强度网织红细胞百分率(LFR%)、高荧光强度网织红细胞百分率(HFR%)和中荧光强度网织红细胞百分率(MFR%)等参数变化较大,有显著性差异(Plt;0.05)。RBC、HGB和HCT在移植后第14天降至最低,以后逐渐升高;在干细胞移植后第7天RET＃、MFR％和HFR％降至最低,LFR％相对增高,随着干细胞移植后骨髓功能逐渐恢复,RET＃也随之升高,HFR在第14天升至最高,MFR在第21天升至最高。结论:观察干细胞移植后外周血细胞参数的变化,对了解干细胞移植后骨髓的恢复有一定的临床价值,本次结果表明HFR可作为了解骨髓恢复的早期指标。
Objective To develop and assess the performance of a predictive model for the infiltration degree of solitary pulmonary pure ground-glass nodules (pGGN) using CT, blood cell parameters, and tumor markers. Methods The clinical data of patients with solitary pulmonary pGGN, collected from Tangshan Gongren Hospital between June 2021 and April 2024, were analyzed. They were divided into a training set and a test set in a 7∶3 ratio. Lasso-logistic regression was used to identify risk factors for invasive adenocarcinoma and construct the model. The model's performance was assessed using receiver operating characteristic (ROC) curves, calibration curves, mean absolute error (MAE), mean squared error (MSE), and accuracy. Results The study included 528 patients (265 males, 263 females) with a median age of 54 years (interquartile range: 45-59). Lasso-logistic regression identified increased diameter, vascular convergence sign, pleural indentation sign, elevated mean CT value, and elevated carcinoembryonic antigen levels as independent risk factors for solitary pulmonary pGGN infiltration. In contrast, a rounded or similarly rounded shape and an elevated platelet-to-lymphocyte ratio were independent protective factors (P<0.05). In the training set, the area under the ROC curve of model Z (comprising diameter, vascular convergence sign, pleural indentation sign, rounded or similarly rounded, mean CT value, carcinoembryonic antigen, and platelet-to-lymphocyte ratio) was 0.875, which was greater than that of model C (comprising diameter, vascular convergence sign, pleural indentation sign, rounded or similarly rounded, and mean CT value; 0.852) and model S (comprising carcinoembryonic antigen and platelet-to-lymphocyte ratio; 0.753). The MAE, MSE, and accuracy of model Z were 0.035, 0.003, and 0.808, respectively, which were lower than those of model C (0.058, 0.006, and 0.827) and higher than those of model S (0.031, 0.001, and 0.648). In the test set, the area under the ROC curve, MAE, MSE, and accuracy of model Z were 0.829, 0.051, 0.004, and 0.755, respectively, which were higher than those of model C (0.780, 0.038, 0.002, and 0.730) and model S (0.740, 0.042, 0.002, and 0.692). Conclusion The model constructed from diameter, vascular convergence sign, pleural indentation sign, rounded or similarly rounded shapes, mean CT value, carcinoembryonic antigen, and platelet-to-lymphocyte ratio aids in assessing the infiltration degree of pulmonary pGGN, with superior performance compared to models based solely on CT or those based on tumor markers combined with blood cell parameters.