NLR值在6岁及以下儿童流感辅助诊断中的应用

Application of neutrophils to lymphocytes ratio for influenza diagnosis of children aged not more than six years old

目的分析甲/乙型流感在学龄前儿童中的流行特点及甲/乙型流感阳性患者与类流感患者的中性粒细胞与淋巴细胞比值(NLR),为今后类流感患者的预防、诊断和治疗提供更多思路与依据。方法统计2017年11月-2018年2月在西安交通大学第二附属医院检验科进行流感病毒抗原筛查的儿童(年龄≤6岁),采集其静脉血或手指末梢血进行血常规检查,运用SPSS 19.0统计软件对其结果进行分析。结果观察378例类流感患者中甲流阳性患者占99例,阳性检出率为26.19%;乙流阳性患者占44例,阳性检出率为11.64%;未感染者225例,甲流患者和非流感患者的NLR值差异有统计学意义(P<0.05)。ROC分析发现,NLR值为0.42时对甲流预测的敏感性为86.1%,特异性为93.2%,曲线下面积(AUC)为0.594。结论 NLR对甲流诊断具有一定的临床诊断价值,可辅助流感病毒抗原筛查对甲流进行诊断。

Objective To analyze the prevalence of influenza A/B in preschool children and neutrophils to lymphocytes ratio(NLR)of influenza A/B positive patients and patients with influenza-like illness,in order to provide more ideas and basis for the prevention,diagnosis and treatment of influenza-like illness. Methods Children who were not more than 6 years old,and screened for antigen of influenza viruses in the Second Affiliated Hospital of Xi′an Jiaotong University,were enrolled in this study from November 2017 to February 2018.The venous blood or finger tip blood of the participants were collected for blood routine test.SPSS 19.0 software was used to analyze data. Results Totally 99(26.19%)cases with positive influenza A were observed in 378 children with influenza-like illness,44(11.64%)cases with positive influenza B,and the 225 cases were not infected.There was significant difference on the value of NLR between patients with influenza A infection and children without infection(P<0.05).When NLR was 0.42,the sensitivity for the prognosis was 86.1%,the specificity was 93.2%,and the area under curve(AUC)was 0.594. Conclusion NLR has certain clinical value for the diagnosis of H1 N1 influenza,and can be helpful to diagnose influenza A virus infection by influenza virus antigen screening.