NLR、MLR及RDW在儿童传染性单核细胞增多症的应用及临床意义

Application and significance of NLR,MLR and RDW in children with infectious mononucleosis

目的分析儿童传染性单核细胞增多症(IM)患儿常见临床检验指标特点,为儿童IM的早期诊断提供更多参考依据。方法选择2019年1月至2021年6月西安市儿童医院住院确诊IM的患儿237例为病例组,同期体检儿童150例为对照组,回顾性分析外周血单核细胞计数、淋巴细胞计数、中性粒细胞和淋巴细胞比值(NLR)、单核细胞和淋巴细胞比值(MLR)及红细胞分布宽度(RDW)在两组中的差异,并将病例组按照年龄和异型淋巴细胞(%)分为不同亚组,比较不同亚组间各项指标的差异。结果病例组中的单核细胞计数、淋巴细胞计数、RDW高于对照组,NLR、MLR低于对照组,差异有统计学意义(P<0.01)。将237例病例组按年龄段分为3组(<3岁62例、3~6岁123例、>6岁52例),3组间MLR、NLR、异型淋巴细胞(%)水平差异均无统计学意义(P>0.05)。根据异型淋巴细胞(%)不同将237例病例组分为3组(异型淋巴细胞<10%70例,10%~20%115例,>20%52例),3组间淋巴细胞计数、CD3^(+)T、CD3^(+)/CD8^(+)T水平差异有统计学意义,异型淋巴细胞(%)>20%组水平最高,异型淋巴细胞(%)<10%组水平最低(P<0.01);3组间MLR、NLR水平差异有统计学意义,异型淋巴细胞(%)>20%组水平最低,异型淋巴细胞(%)<10%组水平最高(P<0.01)。结论NLR、MLR、RDW可作为儿童IM早期诊断指标,T细胞亚群分析可为IM疾病评估提供更多的参考。

Objective To analyze the characteristics of common clinical laboratory tests in children with infectious mononucleosis(IM)to provide referrence for early diagnosis of IM.Methods A total of 237 children with IM hospitalized in Xi'an Children's Hospital between January 2019 and June 2021 were selected as case group,and 150 healthy children for physical examination during the same period were served as control group.The peripheral blood absolute monocyte count,lymphocyte count,neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR)and erythrocyte distribution width(RDW)were detected and compared between two groups.The case group was divided into subgroups according to age and the proportion of heterotypic lymphocytes,and the above-mentioned indicators were also compared between sub groups.Results Compared with control group,the numbers of monocytes,lymphocytes and RDW increased significantly,and NLR and MLR decreased in case group(P<0.01).According to the age,237 cases were divided into three groups(<3 years old,62 cases;aged 3-6 years old,123 cases;>6 years old,52 cases),there was no significant difference in the levels of MLR,NLR and atypical lymphocytes(%)among the three groups(P>0.05).According to the different percentage values of atypical lymphocytes,237 cases were divided into 3 groups(atypical lymphocytes<10%70 cases,10%-20%115 cases,>20%52 cases),the levels of lymphocyte count,CD3^(+)T and CD3^(+)/CD8^(+)T were the highest in the atypical lymphocyte(%)>20%subgroup,and the lowest in the atypical lymphocyte(%)<10%subgroup,and the difference was statistically significant(P<0.01).Conclusion NLR,MLR and RDW can be used as early diagnostic indicators for IM in children.T cell subsets analysis can provide more references for disease assessment.