NLR和RDW在小儿高热惊厥中的表达及其与T淋巴细胞水平的相关性研究  

Expression of neutrophilic granulocyte/lymphocyte ratio and red blood cell distribution width in children with hyperthermic convulsion and their correlation with T lymphocyte level

作　　者：卢一斌 刘占利 马效东[1] LU Yibin;LIU Zhanli;MA XiaoDong(Department of Pediatrics,the Third People′s Hospital of Yuhang,Hangzhou,Zhejiang 311115,China;Department of Pediatrics,Hangzhou First People′s Hospital Affiliated to School of Medicine of Zhejiang University,Hangzhou,Zhejiang 311000,China)

机构地区：[1]浙江省杭州市余杭区第三人民医院儿科,311115 [2]浙江大学医学院附属杭州市第一人民医院儿科,杭州311000

出　　处：《重庆医学》2019年第17期2953-2955,2959,共4页Chongqing medicine

基　　金：2018年省医药卫生学科平台项目(2018KY571)

摘　　要：目的探讨中性粒细胞/淋巴细胞比值(NLR)和红细胞分布宽度(RDW)在小儿高热惊厥(FC)中的表达及与T淋巴细胞水平的相关性。方法选取2016年4月至2017年1月浙江省杭州市余杭区第三人民医院收治的小儿FC 76例,根据临床诊断标准将76例小儿FC分为单纯FC组和复杂FC组,再选取同期来该院行体检的健康儿童38例作为对照组。观察并比较3组儿童的NLR、RDW水平,体内T淋巴细胞的增殖反应情况[即刺激指数(SI)和每分钟脉冲数(CPM)]及T淋巴细胞各项因子(CD3、CD4及CD4/CD8)水平;分析小儿FC与NLR、RDW及T淋巴细胞之间的相关性。结果与对照组比较,复杂FC组及单纯FC组患儿的NLR和RDW均明显升高(P<0.05),复杂FC组较单纯FC组升高更明显(P<0.01);复杂FC组及单纯FC组患儿的SI和CPM均明显降低(P<0.05),复杂FC组较单纯FC组降低更明显(P<0.01)。复杂FC组与单纯FC组患儿的CD3、CD4和CD4/CD8水平均明显低于对照组(P<0.05),且以复杂FC组最低(P<0.01)。小儿FC与NLR、RDW呈明显正相关(r=0.36、0.38,P<0.05),与体内T淋巴细胞的增殖反应指标SI、CPM呈明显负相关(r=-0.40、-0.41,P<0.05);与T淋巴细胞因子CD3、CD4、CD4/CD8呈明显负相关(r=0.39、-0.41、-0.37,P<0.05)。结论患儿的NLR、RDW及T淋巴细胞的水平变化可为临床对小儿FC的诊断及鉴别提供参考依据。Objective To investigate the expressions of neutrophil-to-lymphocyte ratio(NLR)and red blood cell distribution width(RDW)in febrile convulsion(FC)and their correlations with T lymphocyte level.Methods A total of 76 children with FC admitted to our hospital from April 2016 to January 2017 were enrolled.According to the clinical diagnostic criteria,they were divided into the simple FC group and the complex FC group,and then according to 1∶1 of gender and age,38 healthy children who came to our hospital for physical examination at the same time were selected as the control group.The differences of NLR and RDW levels in the three groups,the proliferative response of T lymphocytes in vivo stimulation index(SI)and counts per minute(CPM),the difference of T lymphocyte factors(CD3,CD4,CD4/CD8),the correlation between FC and NLR,RDW,T lymphocytes were observed and compared.Results In terms of NLR and RDW,the complex FC group and the simple FC group were higher than the control group(P<0.05),of which the complex FC group was more higher(P<0.01).In terms of SI and CPM,the complex FC group and the simple FC group were lower than the control group(P<0.05),and the complex FC group was more lower(P<0.01).In terms of CD3,CD4,CD4/CD8,the simple FC group and the complex FC group were lower than the control group,of which the complex FC was the lowest group(P<0.01).FC was positively correlated with NLR and RDW(r=0.36,0.38,P<0.05),negatively correlated with the proliferation response of T lymphocytes SI and CPM(r=-0.40,-0.41,P<0.05),and negatively correlated with the factors of T lymphocytes CD3,CD4 and CD4/CD8(r=-0.39,-0.41,-0.37,P<0.05).Conclusion The changes of NLR,RDW and T lymphocyte levels in children can provide a reference for the diagnosis and identification of FC clinically.

关 键 词：中性粒细胞/淋巴细胞比值 红细胞分布宽度 惊厥 发热性 儿童 T淋巴细胞 

分 类 号：R725.9[医药卫生—儿科]