外周血NLR及PLR水平在早产儿院内感染中的价值研究

Value of peripheral blood NLR and PLR in nosocomial infection of premature infants

目的探究外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)在院内感染(nosoco⁃mial infection,NI)早产儿中的水平及临床意义。方法选取2018年4月—2022年4月开封市儿童医院诊治的76例NI早产儿为感染组,且纳入同期76例未发生NI的早产儿为非感染组。比较非感染组、感染组一般资料;利用全自动血液细胞分析仪测定血小板、淋巴细胞、中性粒细胞水平,计算NLR、PLR;应用受试者工作特征(ROC)曲线评估外周血NLR、PLR水平诊断早产儿NI的价值;logistic回归分析早产儿发生NI的影响因素。结果与非感染组相比,感染组早产儿出生胎龄、男/女比例、出生体重、分娩方式、母亲年龄、绒毛膜羊膜炎比例无明显差异(P>0.05);外周血NLR、PLR水平诊断早产儿NI的曲线下面积(AUC)分别为0.871、0.857,相应敏感度分别为77.6%、73.7%,特异性均为88.2%;外周血NLR、PLR联合诊断早产儿NI的AUC为0.941,敏感度为90.8%,对应特异性为86.8%。妊娠期高血压(hypertensive disorders complicating pregnancy,HDCP)、妊娠期糖尿病(gestational diabetes mellitus,GDM)、NLR、PLR是影响早产儿发生NI的危险因素,差异有统计学意义(P<0.05)。结论NI早产儿外周血NLR、PLR水平升高,NLR、PLR均可作为诊断早产儿NI的指标,且二者联合可能更有助于临床判定早产儿是否发生NI。

Objective To explore the levels and clinical significance of neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in premature infants with nosocomial infection(NI).Methods From April 2018 to April 2022,76 cases of premature infants with NI in Kaifeng Children's Hospital were selected as infection group,and 76 cases of premature infants without NI in the same period were included as non infection group.The general data of non infection group and infec⁃tion group were compared;The levels of platelets,lymphocytes and neutrophils were measured by automatic hematology analy⁃zer,and NLR and PLR were calculated;The receiver operating characteristic(ROC)curve was used to evaluate the value of peripheral blood NLR and PLR levels in the diagnosis of premature NI in premature infants;Logistic regression was used to analyze the influencing factors of NI in premature infants.Results Compared with the non-infected group,there were no significant differences in gestational age,male/female ratio,birth weight,delivery mode,maternal age and chorioamnitis in the infected group(P>0.05);The area under the curve(AUC)of peripheral blood NLR and PLR levels in the diagnosis of premature infants with NI was 0.871 and 0.857,respectively,the corresponding sensitivity was 77.6%and 73.7%,respec⁃tively,and the specificity of both was 88.2%;the AUC of peripheral blood NLR combined with PLR in the diagnosis of NI was 0.941,the sensitivity was 90.8%,and the corresponding specificity was 86.8%.HDCP,GDM,NLR and PLR were the risk factors of NI in premature infants(P<0.05).Conclusion The levels of NLR and PLR in peripheral blood of premature infants with NI are higher.NLR and PLR can be used as indicators for the diagnosis of premature infants with NI,and the combination of NLR and PLR may be more helpful to clinically determine whether NI occurs in premature infants.