6项全身炎症指标对新生儿宫内感染性肺炎的预测价值

Prognostication Value of 6 Systemic Inflammatory Indexes in Neonates with Intrauterine Infectious Pneumonia

目的:分析6项全身炎症指标[包括中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)、全身免疫炎症指数(SII)、泛免疫炎症值(PIV)、全身炎症反应指数(SIRI)]对新生儿宫内感染性肺炎的预测价值。方法:选取2020年3月到2023年3月我院收治的存在胎膜早破、孕母产前发热、合并妊娠糖尿病等危险因素的306例高危新生儿为研究对象,以病原学检查作为“金标准”,将确认为肺炎的226例新生儿作为研究组,非感染性黄疸的新生儿80例作为对照组。所有新生儿在娩出后即刻抽取3mL静脉血并及时进行检测6项全身炎症指标(NLR、PLR、MLR、SII、PIV、SIRI)水平。结果:与对照组相比,研究组胎膜早破、母亲合并糖尿病、母亲产前发热占比较高(P<0.05)。与对照组相比,研究组NLR、PLR、MLR、SII、PIV、SIRI水平较高(P<0.05)。以新生儿是否发生宫内感染性肺炎为因变量(未发生=0;发生=1),选择单因素分析有统计学意义的变量进行多因素Logistics回归分析,结果显示胎膜早破、母亲合并糖尿病、母亲产前发热占比、NLR、PLR、MLR、SII、PIV、SIRI为新生儿发生宫内感染性肺炎的影响因素(P<0.05)。ROC结果显示,与NLR、PLR、MLR、SII、PIV、SIRI单项诊断相比,六项联合诊断新生儿宫内感染性肺炎的敏感性、准确性较高(P<0.05)。结论:宫内感染性肺炎新生儿血清NLR、PLR、MLR、SII、PIV、SIRI水平较高,6项全身炎症指标单项检测预测新生儿宫内感染性肺炎的准确性均达70%以上,联合检测对新生儿宫内感染性肺炎的预测价值高于单一检测。

Objective:To analyze the prognostication value of 6 systemic inflammatory indicators,including neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocyte to lymphocyte ratio(MLR),systemic immune inflammatory index(SII),pan-immune inflammatory value(PIV),and systemic inflammatory response index(SIRI),in neonates with intrauterine infectious pneumonia.Methods:A total of 306 high-risk newborns with premature rupture of membranes,prenatal fever of pregnant mothers and gestational diabetes mellitus admitted to our hospital from March 2020 to March 2023 were selected as the study subjects.With etiological examination as the"gold standard",226 newborns confirmed to be infected with pneumonia were selected as the study group.The control group was 80 non-infectious jaundice neonates.All newborns were given 3mL venous blood immediately after delivery and 6 systemic inflammatory indicators(NLR,PLR,MLR,SII,PIV,SIRI)were detected in time.Results:Compared with the control group,the proportion of premature rupture of membranes,maternal diabetes mellitus and prenatal fever in the study group was higher(P<0.05).Compared with the control group,the levels of NLR,PLR,MLR,SII,PIV and SIRI in the study group were higher(P<0.05).Using the occurrence of intrauterine pneumonia in newborns as the dependent variable(no occurrence=0;occurrence=1),select variables with statistical significance in univariate analysis for multivariate logistics regression analysis,the results showed that premature rupture of membranes,maternal diabetes mellitus,maternal prenatal fever,NLR,PLR,MLR,SII,PIV and SIRI were the influencing factors for the occurrence of intrauterine pneumonia in newborns(P<0.05).ROC curve showed that compared with the single diagnosis of NLR,PLR,MLR,SII,PIV and SIRI,the sensitivity and accuracy of the combined diagnosis of neonatal intrauterine infectious pneumonia were higher(P<0.05).Conclusion:The serum levels of NLR,PLR,MLR,SII,PIV and SIRI of newborns with intrauterine pneumonia were high.The accuracy of the six systemic inflammation indicators in predicting neonatal intrauterine pneumonia was more than 70%,and the combined detection was higher than the single detection in predicting neonatal intrauterine pneumonia.