中性粒细胞/淋巴细胞比值在甲、乙型流感病毒感染患者预测价值分析  

Predictive value of neutrophil/lymphocyte ratio in patients infected with influenza A and B virus

作　　者：孟欣[1] 胡辽辽 张宁[1] 王彩凤[2] MENG Xin;HU Liaoliao;ZHANG Ning;WANG Caifeng(Department of Clinical Laboratory,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shaanxi 710061,China;Department of Emergency,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院检验科,陕西西安710061 [2]西安交通大学第一附属医院急诊科,陕西西安710061

出　　处：《国际检验医学杂志》2019年第20期2464-2467,共4页International Journal of Laboratory Medicine

基　　金：陕西省自然科学基础研究计划项目(2017JM8084)

摘　　要：目的探讨中性粒细胞/淋巴细胞比值(NLR)在甲、乙型流感病毒感染患者预测价值。方法选取2018年1月至2019年2月该院收治的流感病毒感染患者,其中甲型流感3 425例,乙型流感326例,甲型和乙型流感同时阳性7例,同时选取150例体检健康者作为对照。比较白细胞(WBC)、中性粒细胞(NC)、淋巴细胞(LC)、中性粒细胞/淋巴细胞比值(NLR)、C-反应蛋白(CRP)和血小板(PLT)的表达差异。收集甲、乙型流感病毒感染患者的临床和实验室资料,统计分析各指标的差异,并采用ROC曲线分析NC、LC、NLR对甲、乙型流感病毒感染患者的诊断和预测价值。结果14 828例标本中甲型流感病毒阳性占23.10%,乙型流感病毒阳性占2.20%。甲型流感患者WBC、NC、NLR高于乙型流感患者,LC低于乙型流感患者,差异有统计学意义(P<0.05),两组PLT比较差异无统计学意义(P>0.05)。甲型流感患者儿童组和成人组之间WBC、NC、LC、NLR、CRP、PLT差异均有统计学意义(P<0.05)。乙型流感患者儿童组和成人组之间WBC、LC、NLR、CRP、PLT差异均有统计学意义(P<0.05),NC差异无统计学意义(P>0.05)。NLR预测甲型流感曲线下面积为0.76,LC预测甲型流感曲线下面积为0.75。NLR预测甲型流感临界值为3.45(灵敏度57.13%,特异度95.95%),LC预测甲型流感临界值为1.22(灵敏度53.33%,特异度94.00%)。NLR预测乙型流感曲线下面积为0.68,LC预测乙型流感曲线下面积为0.72。NLR预测乙型流感临界值为3.12(灵敏度47.24%,特异度95.33%),LC预测乙型流感临界值为1.34(灵敏度54.60%,特异度87.33%)。结论NLR作为一种独立预测流感患者的生物标志物,尽管其无法完全反映流感患者体内的炎症状态和免疫平衡状态,但其升高对预测甲型、乙型流感阳性患者具有重要的临床价值,能够为流感患者的预后管理提供理论依据。Objective To explore the predictive value of neutrophil/lymphocyte ratio(NLR)in patients with influenza A and B virus infection.Method Patients with influenza virus infection admitted to our hospital from January 2018 to February 2019 were selected,including 3 425 influenza A,326 influenza B,7 influenza A and B positive,and 150 healthy candidates as controls.The expressions of leukocyte(WBC),neutrophil(NC),lymphocyte(LC),neutrophil/lymphocyte ratio(NLR),C-reactive protein(CRP)and platelet(PLT)were compared.The clinical and laboratory data of influenza A and B patients were collected,and the differences of each index were analyzed.The diagnostic and predictive values of NC,LC and NLR for influenza A and B patients were analyzed by ROC curve.Results Among the 14 828 samples,the positive rate of influenza A virus was 23.10%,and that of influenza B virus was 2.20%.WBC,NC and NLR of influenza A patients were higher than those of influenza B patients,LC was lower than those of influenza B patients(P<0.05).There was no significant difference in PLT between the two groups(P>0.05).There were significant differences in WBC,NC,LC,NLR,CRP and PLT between children and adults with influenza A(P<0.05).There were significant differences in WBC,LC,NLR,CRP and PLT between children and adults with influenza B(P<0.05),while there was no significant difference in NC(P<0.05).NLR predicted the area under influenza A curve to be 0.76,LC predicted the area under influenza A curve to be 0.75.NLR predicted a critical value of 3.45(sensitivity 57.13%,specificity 95.95%)and LC predicted a critical value of 1.22(sensitivity 53.33%,specificity 94.00%).NLR predicted the area under the influenza B curve to be 0.68,LC predicted the area under the influenza B curve to be 0.72.NLR predicted a critical value of 3.12(sensitivity 47.24%,specificity 95.33%)and LC predicted a critical value of 1.34(sensitivity 54.60%,specificity 87.33%).Conclusion NLR as a biomarker independently predicts influenza patients,although it can not fully reflect the inflamma

关 键 词：甲型流感病毒 乙型流感病毒 中性粒细胞/淋巴细胞比值 

分 类 号：R511.7[医药卫生—内科学]