外周血炎症细胞比值对小儿肺炎支原体感染诊断价值评价

Clinical Diagnosis Value of the Ratio of Inflammatory Cells in Peripheral Blood in Children Infected with Mycoplasma Pneumoniae

目的 探究血小板/平均血小板体积比值(platelet to mean platelet volume ratio,PMR)、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)以及血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)等外周血炎症细胞比值在小儿肺炎支原体(MP)感染中的变化以及临床诊断价值.方法 选取2018年6月—2018年12月诊断为MP感染的220例患儿为研究对象,另选取健康儿童220名为对照组.检测所有研究对象血常规参数以及C反应蛋白(C-reactive protein,CRP)水平,计算PMR、NLR以及PLR值.通过Spearman相关检验外周血炎症细胞比值与CRP的相关性,受试者工作特征曲线(ROC)分析外周血炎症细胞比值对MP感染的诊断价值.结果 儿童MP感染好发于3~5岁.与对照组相比,MP感染组患儿CRP、外周血白细胞计数、单核细胞计数、单核细胞比率、中性粒细胞计数、中性粒细胞比率、血小板计数、PMR、NLR以及PLR显著升高(P<0.05),淋巴细胞计数以及淋巴细胞比率明显降低(P<0.05).Spearman相关性分析显示PMR、NLR、PLR与CRP呈正相关(r=0.425、0.349、0.447;P<0.001).ROC曲线分析结果 显示CRP、WBC、PMR、NLR及PLR曲线下面积分别为0.802、0.602、0.775、0.787及0.952,且差异有统计学意义(P<0.05).结论 MP感染患儿外周血参数明显改变,而PMR、NLR及PLR可作为一种源于全血细胞参数的炎症指标,对于儿童MP感染的早期诊断具有一定的预测价值.

Objective To explore the change and the clinical diagnosis value of platelet to mean platelet volume ratio(PMR),neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in children infected with Mycoplasma pneumoniae(MP).Methods A total of 220 children infected with MP from June 2018 to December 2018 were selected and 220 healthy children received physical examination in the same period were enrolled in control group.The blood routine examinations and C-reactive protein(CRP)were determined.PMR,NLR and PLR were calculated.The correlation between the ratio of inflammatory cells in peripheral blood and CRP was analyzed by Spearman correlation.The diagnostic value of the ratio of inflammatory cells in peripheral blood in children infected with MP was assessed by ROC curve analysis.Results MP infection is common in children aged 3-5 years.Compared with the control group,CRP level,leukocyte count,monocyte count,monocyte ratio,neutrophil count,neutrophil ratio,platelet count,PMR,NLR and PLR increased significantly(P<0.05);lymphocyte count and lymphocyte ratio decreased significantly in children infected with MP(P<0.05).PMR,NLR and PLR were positively correlated with the CRP level(r=0.425,0.349,0.447;P<0.001).ROC curve analysis showed that the area under the curve of CRP,WBC,PMR,NLR and PLR were 0.802,0.602,0.775,0.787 and 0.952 respectively,and the differences were statistically significant(P<0.05).Conclusion The peripheral blood parameters in children infected with MP were obviously changed,and PMR,NLR and PLR could be used as an inflammatory index derived from the parameters of inflammatory cells in peripheral blood and as a predictor for early diagnosis of MP infection in children.