中性粒细胞/淋巴细胞与淋巴细胞/单核细胞比值变化在儿童紫癜性肾炎中的临床意义

Clinical significance of neutrophil/lymphocyte/lymphocyte/monocyte ratio in children with purpuric nephritis

目的探讨外周血中性粒细胞/淋巴细胞比值(NLR)、淋巴细胞/单核细胞比值(LMR)的变化在儿童紫癜性肾炎诊断中的临床意义。方法选择本院2015年1月-2017年12月所收治的紫癜性肾炎患儿105例作为研究组,根据24 h尿蛋白定量分为轻度蛋白尿组38例、中度蛋白尿组36例和重度蛋白尿组31例,并收集同时期健康儿童115例为对照组,检测入院时各组患者中性粒细胞计数(NEU)、淋巴细胞计数(LYM)、单核细胞计数(MON)和尿微量白蛋白(mAlb),分析各组NLR、LMR和差异性,评估NLR和LMR联合检测对儿童紫癜性肾炎的诊断价值。结果儿童紫癜性肾炎组NLR和mAlb高于对照组,LMR低于对照组,差异均有统计学意义(P<0.05);NLR随过敏性紫癜性肾炎加重呈升高趋势(P<0.05),LMR随病情加重呈下降趋势(P<0.05);NLR和LMR联合检测儿童过敏性紫癜性肾炎的诊断阳性率高于单独检测mAlb,差异均有统计学意义(P<0.05)。结论NLR和LMR可作为评价儿童紫癜性肾炎的有效指标,联合检测诊断价值优于mAlb。

Objective To explore the clinical significance of the changes of peripheral blood neutrophil/lymphocyte ratio(NLR)and lymphocyte/monocyte ratio(LMR)in the diagnosis of childhood purpuric nephritis.Methods A total of 105 children with purpuric nephritis treated in our hospital from January 2015 to December 2017 were selected as the study group.According to the quantitative analysis of 24 h urine protein,they were divided into mild proteinuria group(38 cases)and moderate proteinuria group(36 cases).31 cases of severe proteinuria group and 115 healthy children were collected as the control group,and the neutrophil count(NEU),lymphocyte count(LYM),and monocyte count(MON),and urine microalbumin(mAlb)of each group were measured at admission.NLR,LMR and differences were analyzed between groups,and the diagnostic value of combined detection of NLR and LMR in children with purpuric nephritis was evaluated.Results NLR and mAlb of children with purpuric nephritis were higher than those of the control group,and LMR was lower than that of the control group,with the differences statistically significant(P<0.05);NLR increased with the aggravation of allergic purpuric nephritis,and LMR showed a downward trend with the aggravation of the disease(P<0.05);the positive rate of combined detection of NLR and LMR in children with allergic purpuric nephritis was higher than that of mAlb alone,with the differences statistically significant(P<0.05).Conclusion NLR and LMR can be used as effective indicators to evaluate children with purpuric nephritis,and the combined detection value is better than mAlb.