外周血细胞参数对新生儿感染性肺炎的诊断价值

The value of peripheral blood cell parameters in neonatal infectious pneumonia

目的 分析外周血细胞参数中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)以及血小板体积/淋巴细胞(MPVLR)对新生儿感染性肺炎的早期诊断及病情评估的价值。方法 选取2020年1月~2020年12月在潍坊市人民医院新生儿科住院治疗的102例确诊为感染性肺炎的新生儿,依据病情严重程度分为轻症肺炎组、重症肺炎组,收集中性粒细胞计数(NEU)、淋巴细胞计数(LYM)、血小板计数(PLT)、血小板平均体积(MPV)等血常规指标并计算NLR、PLR、MPVLR等衍生指标,以同期住院的77例非感染性疾病的足月新生儿作为对照进行比较。采用Pearson直线相关分析NLR对新生儿感染性肺炎病情严重程度的评估价值并应用受试者工作特征曲线分析NLR对新生儿感染性肺炎的早期诊断价值。结果 新生儿感染性肺炎组患儿NLR、PLR、PVLR较非感染组患儿明显增高,差异有统计学意义(P<0.05),重症肺炎组患儿较轻症肺炎组患儿NLR差异有统计学意义,PLR、MPVLR在两组患儿比较中差异无统计学意义(P>0.05)。ROC曲线示NLR诊断新生儿感染性肺炎曲线下面积(AUC)为0.806,具有最佳预测效能的NLR截点为1.16,此时敏感度为82.4%,特异度为72.7%。结论 NLR、PLR、MPVLR在新生儿感染性肺炎中存在异常变化,其中NLR与病情进展及严重程度呈正相关,NLR可作为新生儿感染性肺炎的早期诊断指标。

Objective To explore the value of peripheral blood cell parameters such as neutrophils/lymphocytes, platelet/lymphocyte and platelet volume/lymphocyte in the early diagnosis and disease assessment of neonatal infectious pneumonia.Methods Retrospective analysis was performed on 102 neonates diagnosed with infectious pneumonia who were hospitalized in the Department of Neonatology of Weifang People’s Hospital from January 2020 to December 2020.They were divided into mild pneumonia group and severe pneumonia group according to the severity of their illness.Blood routine indexes such as neutrophil count, lymphocyte count, platelet count, mean platelet volume and their derived indices such as NLR,PLR and MPVLR were calculated.Seventy-seven full-term neonates with non-infectious diseases hospitalized during the same period were included as controls.The value of NLR was analyzed by Pearson’s linear correlation in assessing the severity of neonatal infectious pneumonia.The early diagnostic value of NLR for neonatal infectious pneumonia was analyzed by receiver operating characteristic curve.Results NLR,PLR and PVLR in neonatal infectious pneumonia group were significantly higher than those in non-infected group, and the difference was statistically significant(P<0.05).The difference in NLR between children in the severe pneumonia group and those in the mild pneumonia group was statistically significant.There was no significant difference between PLR and MPVLR(P>0.05).The ROC curve showed that the area under the curve of NLR for the diagnosis of neonatal infectious pneumonia was 0.806,and the cut-off point of NLR with the best predictive performance was 1.16,with a sensitivity of 82.4% and specificity of 72.7%.Conclusion There are abnormal changes in NLR,PLR and MPVLR in neonatal infectious pneumonia, and NLR is positively correlated with the severity of pneumonia.NLR can be used as an early diagnostic index of neonatal infectious pneumonia.