NLR和PLR在肺炎支原体肺炎患儿中的意义

Significance of NLR and PLR in children with Mycoplasma pneumoniae pneumonia

目的分析中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)在支原体肺炎(MPP)的临床意义,为临床诊治提供实验室依据。方法回顾性分析2014-2016年苏州大学附属儿童医院住院的968例MPP患儿的临床资料和实验室数据(MPP组),选取同期100例健康体检儿童为对照组,比较MPP组与对照组、重症MPP组及普通MPP组不同胸片改变的NLP及PLR差异。结果(1)MPP组与对照组比较,WBC、N、L计数及PLT、NLR、PLR和CD3^+、CD3^+CD4^+、CD3^-CD19^+、CD3^-CD(16+56)^+、CD19^+CD23^+绝对值、CD4^+/CD8^+、Ig M均高于对照组,Ig A低于对照组,差异均有统计学意义(P<0.05);CD3^+CD8^+绝对值、Ig G差异无统计学意义(P>0.05)。(2)重症MPP组的NLR、PLR及CD3^+、CD3^+CD4^+、CD3^+CD8^+、CD3^-CD19^+、CD19^+CD23^+绝对值和IgA、IgM均高于普通MPP组,L计数、CD4^+/CD8^+均低于普通MPP组,差异均有统计学意义(P<0.05);WBC、N计数及PLT、CD3^-CD(16+56)^+绝对值、Ig G差异无统计学意义(P>0.05)。(3)支气管肺炎组、大叶性肺炎组的NLR和PLR差异均有统计学意义(P<0.05)。(4)NLR与N、L计数成正相关(P<0.05),PLR与WBC计数、CD3^+CD4^+、CD3^-CD(16+56)^+绝对值成负相关(P<0.05),PLR与N、L计数、PLT成正相关(P<0.05)。结论NLR和PLR与支原体肺炎的轻重和免疫紊乱相关,可用于临床辅助评估肺炎支原体肺炎患儿病情。

Objective To analyze the clinical significance of neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in Mycoplasma pneumoniae pneumonia(MPP),provide a laboratory evidence for clinical diagnosis and treatment.Methods The clinical data and laboratory data of 968 children with MPP from Children’s Hospital of Suzhou University from 2014 to 2016 were analyzed retrospectively(MPP group),100 healthy children were selected as control group during the same period.The differences in NLP and PLR were compared between MPP group and control group,severe MPP group and normal MPP group.Results The levels of WBC,N count,L count,PLT,NLR,PLR,CD3^+,CD3^+CD4^+,CD3^-CD19^+,CD3^-CD(16+56)^+,CD19^+CD23^+absolute values,CD4^+/CD8^+,and Ig M level in MPP group were statistically significantly higher than those in control group,Ig A level in MPP group was statistically significantly lower than that in control group(P<0.05).There was no statistically significant difference in CD3+CD8+absolute value and Ig G level between MPP group and control group(P>0.05).NLR,PLR,CD3^+,CD3^+CD4^+,CD3^+CD8^+,CD3^-CD19^+,CD19^+CD23^+absolute values,Ig A and Ig M levels in severe MPP group were statistically significantly higher than those in normal MPP group,L count and CD4^+/CD8^+in severe MPP group were statistically significantly lower than those in normal MPP group(P<0.05).There was no statistically significant difference in WBC,N count,PLT,CD3^-CD(16+56)+absolute value,and Ig G level between severe MPP group and normal MPP group(P>0.05).There were statistically significant differences in NLR and PLR between bronchial pneumonia group and lobular pneumonia group(P<0.05).NLR was positively correlated with N count and L count(P<0.05).NLR was negatively correlated with WBC count,CD3^+CD4^+,CD3^-CD(16+56)+absolute values(P<0.05).NLR was positively correlated with N count,L count,and PLT(P<0.05).Conclusion NLR and PLR are associated with the severity of MPP and immune disorders,which can be used to assist in clinical evaluation of children with MPP.