外周血中性粒细胞与淋巴细胞比值在儿童化脓性脑膜炎预后中的意义  

Significance of the Ratio of Neutrophils to Lymphocytes in Peripheral Blood in Prognosis of Purulent Meningitis in Children

作　　者：王珺[1] 张广超 陈丹[1] 孙晓敏[1] WANG Jun;ZHANG Guangchao;CHEN Dan(General Internal Medicine,Children’s Hospital Affiliated to Zhengzhou University,He’nan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou City,He’nan Province 450000)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院普内一病区,河南省郑州市450000

出　　处：《医学理论与实践》2022年第1期16-18,11,共4页The Journal of Medical Theory and Practice

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190921,LHGJ20190922)。

摘　　要：目的:探讨外周血中性粒细胞与淋巴细胞比值(NLR)在儿童化脓性脑膜炎(PM)预后中的意义。方法:收集2020年5月-2021年5月我院收治的PM患儿80例,并根据严重程度分为轻症组(48例)和重症组(32例),根据预后结局分为预后良好组(61例)和预后不良组(19例);收集同期体检的健康儿60例为健康组;检测两组患儿中性粒细胞(N)、淋巴细胞(L)百分比及二者的比值(NLR);采用多因素Logistic回归分析患儿预后不良的危险因素;ROC曲线分析NLR诊断患儿预后的效能。结果:轻症组和重症组患儿NLR均显著高于健康组(P<0.05),且重症组高于轻症组(P<0.05);预后不良组NLR显著高于预后良好组(P<0.05);多因素分析结果显示,年龄、惊厥、脑脊液糖、外周血NLR均是PM患儿预后的影响因素(P<0.05);ROC曲线分析显示,NLR评估PM患儿预后的曲线下面积为0.743,最佳截断值为2.44,敏感度为81.97%,特异度为78.95%,约登指数为0.609。结论:外周血NLR水平与PM患儿病情及预后有关,高水平NLR是患儿预后不良的危险因素。Objective:To investigate the significance of peripheral blood neutrophil-lymphocyte ratio(NLR)in the prognosis of children with purulent meningitis(PM).Methods:80 PM children who visited our hospital from May 2020 to May 2021 were collected and divided into the mild group(48 cases)and severe group(32 cases)according to the severity.They were also divided into the good prognosis group(61 cases)and poor prognosis group(19 cases)according to the prognosis.60 healthy children who underwent physical examinations during the same period were collected as healthy group.The percentages of neutrophil(N),lymphocyte(L)and the ratio of the two(NLR)were detected.Multivariate Logistic regression was used to analyze the risk factors of prognosis.ROC curve was used to analyze the efficacy of NLR in diagnosing the prognosis of PM children.Results:NLR in mild and severe groups was significantly higher than that in healthy group(P<0.05),and that in severe group was higher than mild group(P<0.05);NLR of poor prognosis group was significantly higher than that of good prognosis group(P<0.05);multivariate analysis showed that age,convulsion,cerebrospinal fluid glucose and peripheral blood NLR were influential factors for the prognosis of PM children(P<0.05);ROC curve analysis showed that the area under the curve of NLR for predicting the prognosis of PM children was 0.743,the best cutoff value was 2.44,the sensitivity was 81.97%,the specificity was 78.95%,and the Youden index was 0.609.Conclusion:The level of NLR in peripheral blood is related to the condition and prognosis of PM children,high level of NLR is a risk factor for their poor prognosis.

关 键 词：化脓性脑膜炎 中性粒细胞与淋巴细胞比值 预后 危险因素 

分 类 号：R742[医药卫生—神经病学与精神病学]