血细胞参数在儿童社区获得性肺炎中的诊断价值分析

Diagnostic Value of Hemocyte Parameters in Community-acquired Pneumonia in Children

目的探讨血细胞参数在儿童社区获得性肺炎诊断的临床价值。方法取2019年1月—2020年12月厦门大学附属妇女儿童医院收治114例患儿,病毒性肺炎感染(病毒组)51例、细菌性肺炎感染(细菌组)18例,病毒与细菌混合肺炎感染(混合组)19例,支原体感染(支原体组)26例,正常对照组49例,采用t检验与非参数秩和检验分析比较5组患儿血细胞参数的差异性,应用受试者工作特征(receiver operating characteristic,ROC)曲线分析不同指标对病毒性肺炎与细菌性肺炎的预测价值。结果(1)混合组与病毒组相比,粒淋比(neutrophil lymphocyte ratio,NLR)升高,差异有统计学意义(P<0.05);(2)细菌组与病毒组相比,NLR、C反应蛋白(C reactive protein,CRP)、中性粒细胞计数(neutrophil,NEU)、血小板计数(platelets,PLT)、白细胞计数(white blood cell,WBC)差异均有统计学意义(P<0.05);(3)混合组与细菌组相比,CRP水平较低,差异有统计学意义(P<0.05);(4)与支原体组相比,细菌组CRP较高,病毒组CRP较低,差异有统计学意义(P<0.05);(5)NLR对于细菌组与病毒组有较好的预测价值,AUC=1,截断值为0.508。结论临床可根据CRP水平和NLR水平辅助鉴别诊断儿童病毒感染、细菌感染及二者混合感染。

Objective To explore the clinical value of hemocyte parameters in the diagnosis of community-acquired pneumonia in children.Methods From January 2019 to December 2020,114 children were admitted to Women and Children’s Hospital Affiliated to Xiamen University.There were 51 cases of viral pneumonia infection(virus group),18 cases of bacterial pneumonia infection(bacteria group),19 cases of mixed virus and bacteria pneumonia(mixed group),26 cases of mycoplasma infection,and 49 cases of normal control group. T-test and non-parametric rank sum test were used to compare the differences in blood cell parameters of the 5 groups. Used receiver operating characteristic (ROC) curve to analyze the predictive value of different indicators for viral pneumonia and bacterial pneumonia. Results (1) Compared the mixed group with the virus group, the neutrophil lymphocyte ratio (NLR) was increased, the difference was statistically significant (P < 0.05). (2) The bacterial group was compared with the virus group, NLR, C-reactive protein (CRP), neutrophil (NEU) count, platelet (PLT) count, and white blood cell (WBC) count were statistically significant (P < 0.05). (3) Compared with the bacterial group, the mixed group had a lower CRP level, and there were statistically significant differences (P < 0.05). (4) Compared with mycoplasma group, the bacterial group had higher CRP and the virus group had lower CRP, and the difference was statistically significant (P < 0.05). (5) NLR had a good predictive value for the bacterial group and the virus group, AUC=1, and the cutoff value was 0.508. Conclusion Clinically, CRP and NLR levels can assist in the differential diagnosis of viral infections, bacterial infections, and mixed infections in children.