LWR、NLR、LMR和PLR对重症新型冠状病毒肺炎的诊断效能

The diagnostic efficacy of LWR,NLR,LMR and PLR in severe cases of coronavirus disease 2019

目的探讨淋巴细胞/白细胞比值(lymphocyte/leukocyte ratio,LWR)、中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)、淋巴细胞/单核细胞比值(lymphocyte/monocyte ratio,LMR)和血小板/淋巴细胞比值(platelet/lymphocyte ratio,PLR)对重症新型冠状病毒肺炎的诊断价值。方法纳入2019年12月30日至2020年1月30日确诊为新型冠状病毒肺炎的患者进行研究,收集一般资料及实验室指标,将患者分为普通组和重症组,使用ROC曲线计算单个连续性变量的AUC及最佳截断值,并计算指标联合诊断的合并预测概率。结果重症组年龄(x^2=24.140,P=0.001)、吸烟(x^2=0.089,P=0.024)高于普通组,差异有统计学意义;重症组淋巴细胞(t=1.232,P=0.034)、LWR(t=2.312,P=0.013)较普通组低,差异有统计学意义;重症组PLR(t=7.231,P=0.003)较普通组高,差异有统计学意义;LWR<0.12、PLR>253.12是新型冠状病毒肺炎发展为重症的危险因素;(LWR+PLR)双指标联合对于诊断新型冠状病毒肺炎发展为重症的灵敏度为81.1%,特异度为58.8%。结论LWR、PLR可用于诊断新型冠状病毒肺炎是否发展为重症,(LWR+PLR)双指标联合较单指标具有更准确的诊断效能。

Objective To evaluate the diagnostic values of lymphocyte/leukocyte ratio(LWR),neutrophil/lymphocyte ratio(NLR),lymphocyte/monocyte ratio(LMR)and platelet/lymphocyte ratio(PLR)for the severe case of coronavirus disease 2019.Methods Patients diagnosed as coronavirus disease 2019 from December 30,2019 to January 30,2020 were included in the study.General information and laboratory indicators were collected.The patients were divided into the general group and the severe group.The area under the curve(AUC)and the optimal cut-off value of single continuous variable were calculated by ROC analysis.The combined prediction probability of diagnosis with combined indices was also calculated.Results Both age(x^2=24.140,P=0.001)and smoking history(x^2=0.089,P=0.024)of the severe group was higher than those of the general group.The differences were statistically significant.Lymphocytes(t=1.232,P=0.034),LWR(t=2.312,P=0.013)and PLR(t=7.231,P=0.003)of the severe group were lower than those of the genereal group.The differences were statistically significant.The risk factors of developing into severe cases of oronavirus disease 2019 were LWR<0.12 and PLR>253.12.The diagnostic sensitivity and specificity of the combination of LWR+PLR for developing into severe cases of oronavirus disease 2019 were 81.1%and 58.8%,respectively.Conclusions LWR and PLR can be used to diagnose the development of oronavirus disease 2019 into severe cases.The combination of LWR+PLR showed higher diagnostic efficacy than single index for accurate diagnosis.