PLR对新生儿缺氧缺血性脑病的诊断价值

Diagnostic Value of PLR in Neonatal Hypoxic Ischemic Encephalopathy

目的:探讨PLR对新生儿缺氧缺血性脑病(HIE)的诊断、病情严重程度评价的临床价值。方法:将笔者所在医院新生儿科2016年10月-2019年6月住院治疗的70例足月HIE患儿设为HIE组,另将同期在笔者所在医院产科生产后体检正常的75例足月新生儿设为对照组。应用CD-1700型血球分析仪测定血小板参数、淋巴细胞计数(LYM)及血小板计数与淋巴细胞计数比值(PLR)。比较两组血小板参数、LYM及PLR水平。比较不同严重程度HIE患儿血小板参数、LYM及PLR水平。采用ROC曲线分析PLR诊断新生儿HIE的价值。结果:HIE组PLT、LYM、PLR均明显低于正常组,MPV、PDW均高于正常组,差异有统计学意义(P<0.05)。重度HIE患儿PLT、LYM、PLR均明显低于中度及轻度HIE患儿,且中度HIE患儿低于轻度HIE患儿,差异有统计学意义(P<0.05)。重度HIE患儿MPV、PDW均明显高于轻度及中度HIE患儿,差异有统计学意义(P<0.05)。ROC曲线显示,PLR诊断新生儿HIE的AUC为0.815,特异度为87%,敏感度为63%,cut off值为40.35,Apgar评分联合PLR的AUC为0.886,特异度为93%,敏感度为87%。结论:PLR诊断新生儿HIE的价值较高,可用于新生儿HIE的诊断、病情判断,非常适用于医疗资源相对不足的基层医院,具有重要的临床意义。

Objective:To explore the clinical value of PLR in the diagnosis and severity evaluation of neonatal hypoxic ischemic encephalopathy(HIE).Method:Seventy cases of full-term HIE children hospitalized in the neonatal department of our hospital from October 2016 to June 2019 were set as the HIE group,and 75 cases of full-term neonates with normal physical examination after delivery in the obstetric department of our hospital during the same period were set as the control group.The platelet parameters,lymphocyte count(LYM)and the ratio of platelet count to lymphocyte count(PLR)were measured by CD-1700 hematocyte analyzer.The platelet parameters,LYM and PLR levels were compared between the two groups.The platelet parameters,LYM and PLR levels of HIE children with different severity were compared.ROC curve was used to analyze the value of PLR in the diagnosis of neonatal HIE.Result:PLT,LYM and PLR in the HIE group were significantly lower than those in the control group,and MPV and PDW were higher than those in the control group,the differences were statistically significant(P<0.05).PLT,LYM and PLR in the severe HIE children were significantly lower than those in the moderate and mild HIE children,and those in the moderate HIE children were lower than those in the mild HIE children,the differences were statistically significant(P<0.05).The MPV and PDW in the severe HIE children were significantly higher than those in the mild and moderate HIE children,and the differences were statistically significant(P<0.05).The ROC curve showed that the AUC of PLR in the diagnosis of neonatal HIE was 0.815,specificity was 87%,sensitivity was 63%and cutoff value was 40.35.The AUC,specificity and sensitivity of Apgar score combined with PLR were 0.886,93%and 87%,respectively.Conclusion:PLR has a high value in the diagnosis of neonatal HIE,and can be used for the diagnosis and condition judgment of neonatal HIE.PLR is very suitable for primary hospitals with relatively insufficient medical resources,and has important clinical significance.