白细胞计数、CRP、NLR及LMR在甲型、乙型流感患儿中的水平变化及临床意义  

Changes and clinical significance of white blood cell count,C-reactive protein,neutrophil/lymphocyte ratio and lymphocyte/monocyte ratio in children with influenza A and influenza B

作　　者：徐霞[1] 黄象维 刘林娜[1] XU Xia;HUANG Xiang-wei;LIU Lin-na(Department of Clinical Laboratory,the Second Afiliated Hospital of Wenzhou Medical University,Zhejiang 325027,China)

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325027

出　　处：《中国卫生检验杂志》2023年第8期998-1001,1005,共5页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨白细胞计数(WBC)、C-反应蛋白(CRP)、中性粒细胞/淋巴细胞比值(NLR)及淋巴细胞/单核细胞比值(LMR)在甲型、乙型流感患儿中的水平变化及临床意义,为临床诊断和治疗提供参考依据。方法选取2022年3月—8月温州医科大学附属第二医院372例甲型流感患儿设为甲型流感组,其中病情加重组41例,37例乙型流感患儿设为乙型流感组,另选99例流感样患儿设为对照组,比较各组CRP、NLR、LMR和WBC等指标的水平变化并分析其临床意义,同时用ROC曲线分析各指标诊断甲型流感和乙型流感的价值。结果甲型流感组WBC低于对照组,高于乙型流感组;乙型流感组WBC、CRP、NLR均低于甲型流感组和对照组,而LMR高于甲型流感组和对照组;甲型流感组WBC、CRP、NLR均高于乙型流感组,而LMR低于乙型流感组,差异均有统计学意义(P<0.05)。ROC曲线分析显示,WBC、CRP、NLR、LMR对甲型流感诊断的AUC分别为0.604、0.543、0.470、0.556,联合检测的AUC为0.655;对乙型流感诊断的AUC分别为0.769、0.747、0.713、0.663,联合检测的AUC为0.793,均高于其单独检测指标。NLR与LMR在甲型流感组中成负相关关系(r=-0.490,P<0.05),乙型流感中成负相关关系(r=-0.605,P<0.05)。结论联合检测WBC、CRP、NLR、LMR对甲型、乙型流感患儿的监测和流感样患儿的鉴别有较大的应用价值。WBC计数较低时,应注意甲型流感或乙型流感的感染,CRP、NLR降低同时LMR升高可为乙型流感病毒的感染提供辅助依据,甲型流感患儿需同时关注CRP、NLR的变化,可预测其是否发生感染与加重情况。Objective This paper aim to explore the level changes and clinical significance of white blood cell count(WBC),C-reactive protein(CRP),neutrophil/lymphocyte ratio(NLR)and lymphocyte/monocyte ratio(LMR)in children with influenza A and influenza B,so as to provide reference for clinical diagnosis and treatment.Methods From March to August of 2022,372 children with influenza A in the Second Affiliated Hospital of Wenzhou Medical University were selected as the influenza A group,of which 41 cases were selected as the aggravation group,37 children with influenza B as the influenza B group,and 99 children with influenza like symptoms as the control group.The levels of CRP,NLR,LMR and WBC in each group were compared and their clinical significance was analyzed.At the same time,the ROC curve was used to analyze the value of each index in diagnosing influenza A and influenza B.Results WBC of influenza A group was lower than that of influenza like group and higher than that of influenza B group;WBC,CRP and NLR of the influenza B group were lower than those of the influenza A group and the influenza like group,while LMR was higher than those of the influenza A group and the influenza like group;WBC,CRP and NLR of the influenza A group were higher than those of the influenza B group,while LMR was lower than that of the influenza B group,with the differences of statistical significance(P<0.05).ROC curve analysis showed that the AUC of WBC,CRP,NLR and LMR in the diagnosis of influenza A was respectively 0.604,0.543,0.470 and 0.556,and the AUC of the combined detection was 0.655;the AUC of the diagnosis of influenza B was respectively 0.769,0.747,0.713 and 0.663,and the AUC of the combined detection was O.793,which were higher than that of single detection.NLR and LMR were significantly negatively correlated in influenza A group(r=-0.490,P<0.05),and negatively correlated in influenza B group(r=-0.605,P<0.05).Conclusion The combined detection of WBC,CRP,NLR and LMR has great application value in the monitoring of children with i

关 键 词：甲型流感病毒 乙型流感病毒 白细胞计数 C-反应蛋白 中性粒细胞/淋巴细胞 淋巴细胞/单核细胞 

分 类 号：R373.1[医药卫生—病原生物学]