儿童支原体脑炎预后的影响因素

Prognostic factors of mycoplasma encephalitis in children

目的分析儿童支原体(MP)脑炎预后的影响因素及中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)预测儿童MP脑炎预后的价值。方法回顾性选取2014-01—2022-01在河南省儿童医院住院治疗的76例MP脑炎患儿,其中预后不良组35例,预后良好组41例。比较2组患儿的临床资料,分析影响支原体脑炎预后的不良因素。采用Logistic回归分析筛选MP脑炎预后的独立危险因素,受试者工作特征(ROC)曲线分析NLR、PLR对MP脑炎预后的评估价值。结果预后不良组患儿出现发热、意识或运动障碍、脑电图异常的发生率高于预后良好组,预后不良组NLR、PLR、脑脊液蛋白量大于预后良好组,差异有统计学意义(P<0.05)。Logistic回归分析提示NLR、PLR、脑电图异常是MP脑炎的独立危险因素。NLR评估MP脑炎预后不良的临界值为1.924,灵敏度为60%,特异性92.7%,ROC曲线下面积为0.749,95%CI:0.632~0.867。PLR评估MP脑炎预后不良的临界值为102.824,灵敏度为82.9%,特异性73.2%,曲线下面积为0.802,95%CI:0.703~0.901。结论NLR、PLR、脑电图异常是MP脑炎的独立危险因素,NLR、PLR可作为评估MP脑炎预后的指标。

Objective To analyze the prognostic factors of mycoplasma encephalitis(MP)in children,and the value of neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in predicting the progno⁃sis of MP in children.Methods Totally 76 children with MP encephalitis hospitalized in Henan Children’s Hos⁃pital from January 2014 to January 2022 were retrospectively selected,and they were divided into a poor progno⁃sis group of 35 cases and a good prognosis group of 41 cases.The clinical data of the two groups were compared to analyze the adverse factors affecting the prognosis of mycoplasma encephalitis.The independent risk factors of MP encephalitis were screened by Logistic regression analysis,and the value of NLR and PLR in the evaluation of MP encephalitis was analyzed by receiver operating characteristic(ROC)curve.Results The incidence of fe⁃ver,disturbance of consciousness or movement and abnormal electroencephalogram in the poor prognosis group was higher than that in the good prognosis group,and the NLR,PLR and cerebrospinal fluid protein in the poor prognosis group were higher than those in the good prognosis group,the difference was statistically significant(P<0.05).Logistic regression analysis suggested that abnormal NLR,PLR and EEG were independent risk factors for mycoplasma encephalitis.The critical value of NLR for poor prognosis of mycoplasma encephalitis was 1.924,the sensitivity was 60%,the specificity was 92.7%,the area under ROC curve was 0.749,95%CI:0.632-0.867.PLR evaluated mycoplasma encephalitis with a critical value of 102.824,sensitivity of 82.9%,specificity of 73.2%,area under curve of 0.802,95%CI:0.703-0.901.Conclusion Abnormal NLR,PLR and EEG are inde⁃pendent risk factors for mycoplasma encephalitis,and NLR and PLR can be used as prognostic indicators for my⁃coplasma encephalitis.