外周血细胞比值变化在儿童传染性单核细胞增多症中的诊断价值

The diagnostic value of changes in peripheral blood cell ratio in children with infectious mononucleosis

目的探讨中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)和淋巴细胞(LYM)计数在儿童传染性单核细胞增多症(IM)中的诊断价值。方法收集2017年9月-2020年3月共134例住院IM患儿的临床及实验室资料,选取同期健康体检儿童共60例为正常对照组。根据外周血检查结果计算NLR、MLR、LYM,并采用ROC曲线分析NLR、MLR及LYM对IM患儿的诊断和预测价值。结果IM患儿MLR、LYM值高于正常对照组,差异有统计学意义(P<0.01),两组的NLR值差异无统计学意义(P>0.05)。ROC表明,NLR的ROC曲线下面积(AUC)为0.397,MLR的AUC为0.648,LYM的AUC为0.680。MLR+LYM的AUC为0.878,最佳界值为0.59,敏感性为82.09%,特异性为85.00%。结论MLR、LYM作为一种独立预测IM患儿的检验指标,两者联合升高对早期诊断IM患儿具有重要的临床价值。

Objective To investigate the diagnostic value of neutrophil/lymphocyte ratio(NLR),monocyte/lymphocyte(MLR),and lymphocyte(LYM)count in children with infectious mononucleosis(IM).Methods Clinical and laboratory data of 134 IM children hospitalized between September 2017 and March 2020 were collected.A total of 60 healthy children during the same period were selected as the control group.The subjects’NLR,MLR,and LYM were calculated according to the results of peripheral blood.The values of NLR,MLR,and LYM in diagnosing and predicting IM were analyzed with ROC.Results The MLR and LYM values of IM children were significantly higher than those of the control group(P<0.01),while the NLR values of the two groups were not statistically significant(P>0.05).ROC results showed that the area under the ROC curve(AUC)of NLR was 0.397,AUC of MLR was 0.648,and LYM's AUC was 0.680.The ROC curve AUC of MLR+LYM was 0.878,the optimal threshold was 0.59,the sensitivity was 82.09%,and the specificity was 85.00%.Conclusion MLR and LYM are independent biomarkers for the prediction of IM in children.