细菌性败血症新生儿白细胞计数、NLR、ELR和血清炎症因子水平变化及临床意义  

Changes and clinical significance of white blood cell counts,NLR,ELR and serum inflammatory factors levels in newborns with bacterial sepsis

作　　者：陆伟伟 周登余[1] 陈亮 LU Wei-wei;ZHOU Deng-yu;CHEN Liang(Department of Neonatology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China;The First Clinical College of Anhui Medical University,Hefei 230022,Anhui,China)

机构地区：[1]安徽医科大学第一附属医院新生儿科,安徽省合肥市230022 [2]安徽医科大学第一临床医学院,安徽省合肥市230022

出　　处：《广西医学》2022年第17期1950-1954,1973,共6页Guangxi Medical Journal

基　　金：安徽省自然科学基金(1808085QH238)。

摘　　要：目的探讨细菌性败血症新生儿白细胞计数、中性粒细胞/淋巴细胞比值(NLR)、嗜酸性粒细胞/淋巴细胞比值(ELR)和血清炎症因子水平变化及临床意义。方法纳入80例细菌性败血症新生儿、60例普通细菌感染新生儿、80例健康新生儿分别作为观察组、对照组、空白对照组。比较3组新生儿之间,不同病情程度的细菌性败血症新生儿之间,以及细菌性败血症新生儿治疗前后,白细胞计数、NLR、ELR及血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-8、C反应蛋白(CRP)水平。采用Pearson检验分析观察组上述指标与新生儿危重评分的相关性;采用Logistic回归模型分析上述指标与新生儿细菌性败血症的相关性。结果空白对照组、对照组、观察组的白细胞计数、NLR、ELR,以及血清TNF-α、IL-6、IL-8、CRP水平依次升高(均P<0.05)。非危重、危重、极危重细菌性败血症患儿的白细胞计数、NLR、ELR,以及血清TNF-α、IL-6、IL-8、CRP水平依次升高(均P<0.05)。细菌性败血症新生儿上述指标与新生儿危重评分呈正相关,且治疗10 d后上述指标水平较治疗前下降(均P<0.05)。Logistic回归分析结果显示,白细胞计数、NLR、ELR,以及血清TNF-α、IL-6、IL-8、CRP水平与新生儿细菌性败血症相关(均P<0.05)。结论细菌性败血症新生儿白细胞计数、NLR、ELR及炎症因子水平明显升高,且随病情加重呈增高趋势。上述指标可为临床早期诊断新生儿细菌性败血症、评估病情进展、制定合理的临床治疗方案提供更多参考。Objective To investigate the changes and clinical significance of white blood cell counts,neutrophilto-lymphocyte ratio(NLR),eosinophil-to-lymphocyte ratio(ELR),and serum inflammatory factors levels.Methods A total of 80 newborns with bacterial sepsis,60 newborns with common bacterial infection,and 80 healthy newborns were enrolled in observation group,control group,or blank control group,respectively.The white blood cell counts,NLR,ELR,and serum tumor necrosis factorα(TNF-α),interleukin(IL)-6,IL-8 and C-reactive protein(CRP)levels were compared between the three groups,between newborns with bacterial sepsis in different severities,and between newborns with bacterial sepsis before and after treatment.The Pearson test was performed to analyze the correlation of indices as mentioned above with neonatal critical illness score;furthermore,the Logistic regression model was used to analyze the correlation of aforesaid indices with neonatal bacterial sepsis.Results The white blood cell counts,NLR,ELR,and levels of serum TNF-α,IL-6,IL-8,and CRP were increased successively in the blank control,control and observation groups(all P<0.05).The white blood cell counts,NLR,ELR,and levels of serum TNF-α,IL-6,IL-8,and CRP were increased successively in the newborns with non-critical,critical,and extremely critical bacterial sepsis(all P<0.05).The aforementioned indices of newborns with bacterial sepsis positively correlated with neonatal critical illness score,and the levels of aforesaid indices were decreased 10 days after treatment as compared with before treatment(all P<0.05).The results of Logistic regression analysis revealed that the white blood cell counts,NLR,ELR,and levels of serum TNF-α,IL-6,IL-8,and CRP were related to neonatal bacterial sepsis(all P<0.05).Conclusion The white blood cell counts,NLR,ELR,and inflammatory factors levels in the newborns with bacterial sepsis are significantly increased,and they tend to increase with the aggravation of the disease.The aforesaid indices can provide more reference for ea

关 键 词：细菌性败血症 新生儿 白细胞计数 中性粒细胞/淋巴细胞比值 嗜酸性粒细胞/淋巴细胞比值 炎症因子 

分 类 号：R722.131[医药卫生—儿科]