小儿高热惊厥患者NLR、RDW检测及其临床价值  

Detection of neutrophil-lymphocyte ratio and red blood cell volume distribution width in children with febrile convulsion and its clinical value

作　　者：刘艳艳 李焕 LIU Yan-yan;LI Huan(Department of Pediatrics,Department of Clinical Laboratory,Nanyang 473000,Henan,CHINA;the Second People's Hospital of Nanyang City,Nanyang 473000,Henan,CHINA)

机构地区：[1]南阳市第二人民医院儿科,河南南阳473000 [2]南阳市第二人民医院检验科,河南南阳473000

出　　处：《海南医学》2020年第4期463-466,共4页Hainan Medical Journal

摘　　要：目的探究中性粒细胞与淋巴细胞比值(NLR)和红细胞体积分布宽度(RDW)对小儿高热惊厥患者的临床诊断价值。方法回顾性分析南阳市第二人民医院2017年10月至2019年5月接诊的小儿高热惊厥患者75例的诊疗情况。根据临床诊断分为单纯组56例和复杂组19例,选取同期健康儿童37例作为对照组。比较三组受检儿童入院初次实验室检查的血常规指标,包括红细胞计数(RBC)、血红蛋白(Hb)、血细胞比容(HCT)、白细胞计数(WBC)、中性粒细胞与淋巴细胞比值(NLR)、红细胞体积分布宽度(RDW)。根据NLR、RDW检测的结果绘制受试者ROC曲线,计算灵敏度、特异性和ROC曲线下面积,寻找诊断界限Cut-off值,评价诊断价值。结果对照组儿童的RBC、WBC、NLR、RDW水平分别为(3.52±0.55)×1012/L、(5.33±2.13)×109/L、1.72±1.04、(11.41±0.87)%,明显低于单纯组的(4.36±0.47)×1012/L、(12.79±5.03)×109/L、2.43±1.22、(15.43±1.68)%和复杂组的(4.51±0.51)×1012/L、(13.65±5.88)×109/L、3.86±1.36、(17.32±1.99)%,而单纯组患儿的NLR和RDW明显低于复杂组,差异均有统计学意义(P<0.05),但单纯组与复杂组患儿的RBC、WBC比较差异均无统计学意义(P>0.05);对照组儿童的Hb、HCT水平分别为(153±18.4) g/L、(52.51±5.82)%,明显高于单纯组的(115±10.2) g/L、(40.21±4.51)%和复杂组的(116±12.7) g/L、(42.19±3.58)%,差异均有统计学意义(P<0.05),而单纯组与复杂组患儿的Hb、HCT比较差异均无统计学意义(P>0.05);根据ROC曲线计算可知,NLR检测鉴别单纯高热惊厥和复杂高热惊厥的灵敏度为65.6%,特异度为66.3%,线下面积为0.672,最佳Cutoff值为2.51;RDW检测鉴别单纯FC和复杂FC的灵敏度为62.2%,特异度为58.9%,线下面积为0.622,最佳Cut-off值为16.48。结论 NLR和RDW检测能够为临床鉴别单纯型和复杂型高热惊厥提供一定的理论依据。Objective To explore the clinical diagnostic value of neutrophil-lymphocyte ratio(NLR) and red blood cell volume distribution width(RDW) in children with febrile convulsion, and provide guidance for clinical diagnosis of patients. Methods A retrospective analysis of 75 children of pediatric febrile convulsion in the Second People’s Hospital of Nanyang City from October 2017 to May 2019 was performed. According to different clinical diagnosis, the patients were divided into the simple group(56 patients) and the complex group(19 patients). Thirty-seven healthy children were selected as the control group. Blood routine indicators of initial laboratory tests in three groups were included, including red blood cell count(RBC), hemoglobin(Hb), hematocrit(HCT), white blood cell count(WBC), NLR, and RDW. According to the results of NLR and RDW detection, the subject ROC curve was drawn, the sensitivity, specificity and area under the ROC curve were calculated, and the cut-off value of the diagnostic limit was found to evaluate the diagnostic value. Results The RBC, WBC, NLR, and RDW levels in the control group were(3.52±0.55)×1012/L,(5.33±2.13)×109/L, 1.72±1.04,(11.41±0.87)%, which were significantly lower than(4.36±0.47)×1012/L,(12.79±5.03)×109/L, 2.43±1.22,(15.43±1.68)% in the simple group and(4.51±0.51)×1012/L,(13.65±5.88)×109/L, 3.86±1.36,(17.32±1.99)% in the complex group, and the levels of NLR and RDW in simple group were significantly lower than those in complex group(P<0.05). There was no significant difference in RBC and WBC between simple group and complex group(P>0.05). The levels of Hb and HCT in the control group were(153±18.4) g/L,(52.51±5.82)%, which were significantly higher than(115±10.2) g/L,(40.21±4.51)% in the simple group and(116±12.7) g/L,(42.19±3.58)% in the complex group(P<0.05). There was no significant difference in Hb and HCT between the simple group and the complex group(P>0.05). According to the calculation of ROC curve, the sensitivity of NLR detection to identify pu

关 键 词：高热惊厥 儿童 中性粒细胞与淋巴细胞比值 红细胞体积分布宽度 诊断价值 

分 类 号：R725[医药卫生—儿科]