中性粒细胞-淋巴细胞比值和红细胞分布宽度在小儿高热惊厥分型中的诊断价值研究

The diagnostic role of neutrophil-lymphocyte ratio and red blood cell distribution width in the classification of febrile seizures

目的回顾性分析高热惊厥患儿中性粒细胞-淋巴细胞比值(NLR),红细胞分布宽度(RDW)和评价二者鉴别诊断单纯型和复杂型小儿高热惊厥的诊断价值。方法选择年龄在6个月到5岁之间的患儿100例,均为初诊小儿高热惊厥急诊入院,入院时均采集指尖外周血检测血常规。结果单纯型和复杂型小儿高热惊厥组的NLR平均值分别为2.16±1.26和3.62±1.51,RDW平均值分别为15.04±1.73和16.89±1.44。本研究利用受试者工作特征曲线(ROC曲线)分析以2.52作为NLR的cut-off值,其灵敏度和特异度分别为65.5%和66.2%,ROC曲线下面积AUC为0.670。RDW的cut-off值为16.47,灵敏度和特异度分别为62.1%和59.3%,ROC曲线下面积AUC为0.619。结论本研究发现NLR和RDW可能为临床医生鉴别单纯型和复杂型小儿高热惊厥提供一定实验依据,但诊断价值还有待提高。

Objective To evaluate he significance of the Neutrophil-Lymphocyte Ratio （NLR） and the red blood cell （erythrocyte） distribution width （RDW） in distinguishing between simple and complex febrile seizures and evaluate the diagnostic values of NLR and RDW in febrile seizures. Methods Totally, 100 patients aged between 6 months and 5 years diagnosed with febrile seizure were admitted to the emergency department of the hospital. Complete blood count obtained from the peripheral blood samples collected from the patients at admission were evaluated. Results The average values of NLR for simple and complex seizure groups were 2.16 ±1.26 and 3.62 ±1.51 respectively. The average values of RDW for simple and complex seizure groups were 15.04 ±1.73 and 16.89 ±1.44, respectively. Using receiver operating characteristic curve （ROC）, the sensitivity and specificity were 65.5% and 66.2%, respectively, with the area under the curve [AUC] of 0.670 when the cut-off value was 2.52 for NLR, and they were 62.1% and 59.3%, respectively, with AUC of 0.619 when the cut-off value was 16.47 for RDW. Conclusion NLR and RDW may provide clinicians with an insight into differentiation between simple and complex febrile seizures, however, we need much better diagnostic value to classify the febrile seizures