中性粒细胞/淋巴细胞比值在儿童重症肺炎中的诊断价值  

Diagnostic value of neutrophil-to-lymphocyte ratio in children with severe pneumonia

作　　者：蒋伟燕[1] 李航逸 瞿晓晓 李绵绵[1] 赖媚媚[1] 余玲玲[1] JIANG Wei-yan;LI Hang-yi;QU Xiao-xiao;LI Mian-mian;LAI Mei-mei;YU Ling-ling(Department of Clinical Laboratory,the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China;不详)

机构地区：[1]温州医科大学附属第二医院临床检验中心,浙江温州325027 [2]温州医科大学检验医学院生命科学学院,浙江温州325035

出　　处：《中国卫生检验杂志》2022年第11期1330-1333,共4页Chinese Journal of Health Laboratory Technology

基　　金：温州市基础性科研项目(Y20210100)。

摘　　要：目的 探讨中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)在儿童重症肺炎诊断和鉴别诊断中的临床价值。方法 回顾性分析2011年2月-2021年6月本院收住的211例重症肺炎患儿及同期80例健康体检儿童临床资料和实验室数据。其中,细菌性肺炎59例(细菌性肺炎组)、病毒性肺炎40例(病毒性肺炎组)、支原体肺炎33例(支原体肺炎组)、细菌性肺炎合并病毒感染42例(细菌性肺炎合并病毒感染组)、细菌性肺炎合并支原体感染37例(细菌性肺炎合并支原体感染组),比较各感染组与对照组之间外周血白细胞总数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LYMP)、NLR和C-反应蛋白(CRP)的差异。结果 细菌性肺炎组的NLR显著高于病毒性肺炎组、支原体肺炎组和对照组(P <0.05),细菌性肺炎合并病毒感染组和细菌性肺炎合并支原体感染组的NLR显著高于病毒性肺炎组和支原体肺炎组(P <0.05)。在细菌性重症肺炎的诊断中,NLR的ROC曲线下面积(AUC)为0.76,WBC的AUC为0.69,CRP的AUC为0.75,NLR和CRP联合检测的AUC为0.81,WBC和CRP联合检测的AUC为0.78,WBC、CRP和NLR三者联合检测的AUC为0.82。WBC和CRP联合检测的AUC显著大于WBC单项检测,NLR、WBC和CRP联合检测的AUC显著大于WBC和CRP联合检测(P <0.05)。结论 NLR在儿童重症肺炎的诊断和鉴别诊断中有一定价值。Objective To explore the clinical value of neutrophil-to-lymphocyte ratio(NLR)in the diagnosis and differential diagnosis of severe pneumonia in children.Methods The clinical information and laboratory data of 211 children with severe pneumonia and 80 healthy children from February 2011 to June 2021 were analyzed retrospectively.59 cases of bacterial pneumonia(bacterial pneumonia group)and 40 cases of viral pneumonia(viral pneumonia group),33 cases of mycoplasma pneumonia(mycoplasma pneumonia group),42 cases of bacterial pneumonia complicated by virus infection(bacterial pneumonia with virus infection group),37 cases of bacterial pneumonia merger mycoplasma infection(bacterial pneumonia merger mycoplasma infection group)were grouped to compare the total number of white blood cells(WBC),neutrophil count(NEUT),lymphocyte count(LYMP),NLR and C-reactive protein(CRP)between the infected group and the control group.Results NLR of bacteria pneumonia group was significantly higher than that of virus pneumonia group,mycoplasma group and the control group(P<0.05),and NLR of bacteria pneumonia with virus infection group and bacteria pneumonia with mycoplasma infection group were significantly higher than that of virus pneumonia and mycoplasma pneumonia group(P<0.05).In the diagnosis of severe bacterial pneumonia,AUC of NLR was 0.76,AUC of WBC was 0.69,AUC of CRP was 0.75,AUC of NLR and CRP was 0.81,AUC of WBC and CRP was 0.78,AUC of WBC,CRP and NLR was 0.82.The AUC of WBC and CRP was significantly higher than that of WBC,and the AUC of NLR,WBC and CRP was significantly higher than that of WBC and CRP(P<0.05).Conclusion NLR has certain value in the diagnosis and differential diagnosis of severe pneumonia in children.

关 键 词：中性粒细胞/淋巴细胞比值 儿童 重症肺炎 ROC曲线 

分 类 号：R725.6[医药卫生—儿科]