NLR、PLR联合CRP检测对手足口病患儿的临床价值

The diagnostic value and clinical significance of NLR,PLR and CRP for children with Hand Foot and Mouth Disease

目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)联合C反应蛋白(CRP)检测对手足口病(HFMD)患儿的临床诊断。方法将2016年5月至2017年9月该院住院的HFMD患儿112例作为病例组,并按病情分为普通组、重症组、危重症组及病死组,另以该院健康体检儿童42例作为对照组。检测2组研究对象的血常规和生化结果,收集白细胞(WBC)、中性粒细胞(NEUT)、淋巴细胞(LYMPH)、血小板(PLT)、CRP检查结果数据,并计算NLR、PLR值。结果随疾病加重,WBC、NEUT、LYMPH、NLR、PLR、CRP等免疫炎性指标水平呈升高趋势。2组WBC、CRP水平比较,差异均有统计学意义(P<0.01);NEUT、NLR水平在危重组、重症组、普通组之间比较,差异有统计学意义(P<0.05);重症组和普通组LYMPH高于对照组(P<0.05);各组PLT、PLR水平均高于普通组和对照组(P<0.05),其余各组间比较,差异无统计学意义(P>0.05)。且NLR与WBC(R^2=0.34)、CRP(R^2=0.39)及PLR与WBC(R^2=0.21)、CRP(R^2=0.41)呈正相关(P<0.05)。结论 NLR、PLR联合CRP检测与HFMD的发生、发展密切相关,可作为一种经济、简便的炎性指标,用于HFMD的诊疗及预后判断。

Objective To explore the diagnostic value and clinical significance of NLR,PLR and CRP for Hand Foot and Mouth Disease,and providing laboratory new ideas for the diagnosis and treatment of HFMD. Methods A total of 112 patients （they were divided as general group,severity group,critical group and death group） and 42 healthy children were included as the research objects from May 2016 to September 2017 in our hospital.The index of blood routine and biochemistry were detected in the early admission,the data of the patients′ WBC,NEUT,LYMPH,PLT and CRP were collected and the NLR and PLR were calculated. Results The level of immune inflammatory indicators such as WBC,NEUT,LYMPH,NLR,PLR and CRP were elevated with the aggravation of HFMD.The changes of WBC and CRP were statistically significant in comparison between groups （ P 〈0.01）.The levels of NEUT and NLR were significantly difference between the severity group,the severity group and the general group （ P 〈0.05）.The LYMPH of patients in the severity group and the normal group were higher than which in the control group （ P 〈 0.05）.PLT and PLR levels were higher in each group than which in normal group and control group （ P 〈 0.05 ）.There was no difference between the other groups.Furthermore,NLR with WBC（ R 2=0.34）,CRP （ R 2= 0.39 ） and PLR with WBC （ R 2= 0.21 ）,CRP（ R 2=0.41） were positive correlation. Conclusion NLR,PLR and CRP are closely related to the development of HFMD,which can be used as an economic and simple inflammatory index for the diagnosis and prognosis of HFMD.