中性粒细胞淋巴细胞比值在流行性感冒肺炎患者中的诊断价值

Clinical value of neutrophil-to-lymphocyte ratio in patients with influenza pneumonia

目的:探讨中性粒细胞淋巴细胞比值(NLR)在甲、乙型流感肺炎中的诊断价值。方法:选取2017年1月—2018年12月南京鼓楼医院集团宿迁医院收治的189例流行性感冒患者,分为无肺炎组(n=103)与肺炎组(n=86)。比较肺炎组与无肺炎组白细胞(WBC)、中性粒细胞(NC)、淋巴细胞(LC)、血小板(PLT)和NLR等指标的差异。采用Logistics回归分析与甲、乙型流感病毒感染肺炎患者的相关危险因素,并采用ROC曲线分析中性粒细胞淋巴细胞比值对甲、乙型流感病毒感染肺炎患者的诊断价值。结果:流感肺炎组NC、NLR、PLR高于无肺炎组,差异有统计学意义(P<0.05),LC、LMR低于无肺炎组,差异有统计学意义(P<0.05);多因素logistics回归分析结果显示,NLR、LMR是流行性感冒并发肺炎的独立相关危险因素(P<0.05),与NLR呈正相关(P<0.05),与LMR呈负相关(P<0.05)。在诊断流行性感冒并发肺炎方面,NLR的受试者操作特征曲线下面积为0.676,95%CI为0.600~0.752,最佳临界值为3.175,灵敏度、特异度分别为40.2%、92.4%,高于LMR。结论:中性粒细胞淋巴细胞比值是流行性感冒肺炎一种独立相关危险因素,其数值的升高对诊断流感合并肺炎患者有一定的意义,能够为流感肺炎非影像学检查提供一定的诊断价值。

Objective To analyze the clinical value of neutrophil-to-lymphocyte ratio(NLR)in influenza A and B pneumonia.Methods 189 patients with influenza admitted to Suqian Hospital of Nanjing Drum Tower Hospital Group from January 2017 to December 2018 were selected and divided into pneumonia free group(n=103)and pneumonia group(n=86).Compare the differences in indicators such as white blood cells(WBC),neutrophils(NC),lymphocytes(LC),platelets(PLT),and NLR between the pneumonia group and the pneumonia free group.Logistic regression analysis was used to identify the risk factors associated with pneumonia caused by influenza A and B viruses,and ROC curve analysis was used to assess the diagnostic value of neutrophil lymphocyte ratio in patients with pneumonia caused by influenza A and B.Result The NC,NLR,and PLR of the influenza pneumonia group were higher than those of the non pneumonia group,with a statistically significant difference(P<0.05).The LC and LMR were lower than those of the pneumonia free group,with a statistically significant difference(P<0.05);Multivariate logistic regression analysis showed that NLR and LMR were independent risk factors for influenza complicated with pneumonia(P<0.05),positively correlated with NLR(P<0.05),and negatively correlated with LMR(P<0.05).In the diagnosis of influenza complicated with pneumonia,the area under the operating characteristic curve of subjects in NLR was 0.676,95%CI was 0.600~0.752,the optimal critical value was 3.175,and the sensitivity and specificity were 40.2%and 92.4%,respectively,higher than LMR.Conclusion The neutrophil lymphocyte ratio is an independent risk factor for influenza pneumonia.The increase of its value has certain significance for the diagnosis of influenza patients with pneumonia,and can provide certain diagnostic value for non imaging examinations of influenza pneumonia.