中性粒细胞与淋巴细胞比值在儿童难治性肺炎支原体肺炎中的诊断及预测价值

Application of neutrophil/lymphocyte ratio in the diagnosis and prediction of refractory Mycoplasma pneumoniae pneumonia in children

目的探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)作为标志物对儿童难治性肺炎支原体肺炎(refractory mycoplasma pneumoniae pneumonia,RMPP)的诊断及预测价值。方法回顾性选取2021年1月—2021年12月在徐州市儿童医院呼吸二科住院的142例肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿作为研究对象,分为普通MPP组(101例)、RMPP组(41例)。通过查看电子病历,比较2组临床资料、白细胞计数(WBC)、中性粒细胞比例(NEU)、血小板计数(PLT)、NLR、C-反应蛋白(CRP)及降钙素原(PCT)指标。应用受试者工作特性(receiver operating characteristic,ROC)曲线确定差异有统计学意义的3种生物标志物的截断值,使用Logistic回归分析识别RMPP的独立预测因子。结果2组患儿均有咳嗽症状,2组性别差异无统计学意义(P>0.01);RMPP组年龄、发热症状、NEU、NLR、CRP与普通MPP组相比差异有统计学意义(均P<0.01),NLR在诊断RMPP患儿ROC曲线下面积(area under the curve,AUC)为0.854,特异度和敏感度分别是79.2%、87.8%,二元Logistic回归分析表明,NLR、NEU和CRP为RMPP的独立危险因素(均P<0.01),相对危险程度NLR>CRP>NEU。结论NLR可作为RMPP的诊断及预测指标。

Objective To evaluate the application of neutrophil to lymphocyte ratio(NLR)as a marker in the diagnosis and prediction of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 142 patients with Mycoplasma pneumoniae pneumonia(MPP)who were admitted to the Second Department of Respiratory Medicine,Xuzhou Children′s Hospital from January 2021 to December 2021 were selected and their clinical data were retrospectively analyzed.They were divided into two groups:a common MPP group(n=101)and a RMPP group(n=41).Both groups were compared for clinical data,white blood cell(WBC),neutrophil(NEU),platelet(PLT),NLR,C-reactive protein(CRP)and procalcitonin(PCT).A receiver operating characteristic curve(ROC)was plotted to determine the cut-off values of three biomarkers with statistical significance.Logistic regression analysis was performed to identify the independent predictors of RMPP.Results Children in both groups presented cough,while no statistical difference was found in sex between the two groups(P>0.01).There were statistical differences in age,fever,NEU,NLR and CRP between the RMPP group and the MPP group(all P<0.01).The area under the ROC(AUC)of NLR in diagnosing RMPP patients was 0.854,with a specificity of 79.2%and a sensitivity of 87.8%.According to the binary logistic regression analysis,NLR,NEU and CRP were the independent risk factors for RMPP(all P<0.01),with a relative risk range of NLR>CRP>NEU.Conclusions NLR can be used as an indicator for the diagnosis and prediction of RMPP.