中性粒细胞与淋巴细胞比值对乙型流感病毒感染患儿疗效及预后的预测价值

Effects of Neutrophil-Lymphocyte Ratio on Efficacy and Prognosis Prediction Value of Children with Influenza B Virus Infection

目的:探讨中性粒细胞与淋巴细胞比值(NLR)对乙型流感病毒感染患儿疗效评估及预后的预测价值。方法:回顾性分析2016年10月至2018年4月我院收治的304例乙型流感病毒感染患儿的临床资料,统计可能导致预后不良的相关因素,比较预后良好组和不良组可能影响因素的差异,并采用Logistic回归分析法明确相关危险因素。根据年龄将患儿分为A组(<6岁)、B组(≥6岁)。收集治疗前NLR,比较两组患儿、治疗有效组和无效组、预后良好组和预后不良组NLR;通过绘制受试者工作特征曲线(ROC曲线),分析NLR对2年龄段乙型流感病毒感染患儿疗效评估及预后的预测效果。结果:预后良好组和预后不良组性别、有肥胖症、病程、1年内流感疫苗接种史、合并急性呼吸窘迫、肝功能不全、心功能不全、咳血、呕吐患者构成比比较,差异均无统计学意义(P>0.05);预后不良组年龄<6岁、合并严重低氧血症、细菌感染、肾功能不全、免疫系统疾病、NLR>3.25患儿构成比均高于预后不良组(P<0.05),且经Logistic回归分析证实均是导致预后不良的危险因素。A组、B组患儿治疗有效率分别为77.66%、82.76%,且两组中有效组患儿NLR均低于无效组(P<0.05);A组、B组患儿预后不良发生率分别为11.70%、2.59%,两组中预后良好组患儿NLR均低于预后不良组(P<0.05);NLR对A组、B组乙型流感病毒感染患儿疗效评估最佳截断点分别为1.58、2.35,准确度分别为95.21%、93.97%,AUC分别为0.896、0.902;NLR对A组、B组乙型流感病毒感染患儿预后预测的最佳截断点分别为2.85、6.35,准确度分别为91.49%、96.55%,AUC分别为0.853、0.913。结论:NLR>3.25是乙型流感病毒感染患儿预后不良的危险因素,且NLR对不同年龄段乙型流感病毒感染患儿疗效及预后预测均有较高的预测价值。

Objective:To probe into the effects of neutrophil-lymphocyte ratio on efficacy evaluation and prognosis prediction value of children with influenza B virus infection.Methods:Clinical data of 304 children with influenza B virus infection admitted into our hospital from Oct.2016 to Apr.2018 were retrospectively analyzed.The related factors that may lead to poor prognosis were counted,and the differences of the possible influencing factors between the good prognosis group and the poor prognosis group were compared,and the related factors were determined by Logistic regression analysis.NLR before treatment were collected,NLR were compared among two groups of children,the effective group,ineffective group,good prognosis group and poor prognosis group.Receiver operating characteristic(ROC)curve was drawn to analyze the efficacy and prognosis prediction of NLR in children with influenza B virus infection of two age groups.Results:There were no significant difference in the proportion of gender,obesity,course of disease,influenza vaccination history within one year,acute respiratory distress,hepatic insufficiency,cardiac insufficiency,hemoptysis and vomiting between the good prognosis group and the poor prognosis group(P>0.05),while the proportion of children aged<6 years,with severe hypoxemia,bacterial infection,renal insufficiency,immune system diseases,NLR>3.25 in the good prognosis group were higher than those in the poor prognosis group(P<0.05),Logistic regression analysis proved that the above indicators were risk factors for poor prognosis.The effective rates of group A and group B were respectively 77.66%and 82.76%,and NLR of the effective group was lower than that of the ineffective group(P<0.05).The incidences of poor prognosis of group A and B were respectively 11.70%and 2.59%,and NLR in the good prognosis group were lower than those in the poor prognosis group(P<0.05).The best cut-off points for NLR to evaluate the efficacy of group A and B for children with influenza B virus infection were 1.58 and 2.35,with accuracy of 95.21%and 93.97%,and AUC of 0.896 and 0.902.The best cut-off points of NLR for predicting the prognosis of children with influenza B virus infection in group A and B were 2.85 and 6.35,with accuracy of 91.49%and 96.55%,and AUC of 0.853 and 0.913.Conclusion:NLR>3.25 is a risk factor for poor prognosis of children with influenza B virus infection,and NLR has higher predictive value in efficacy and prognosis prediction of children with influenza B virus infection in different age groups.