中性粒细胞计数与淋巴细胞计数比值联合血生化指标对危重症腺病毒肺炎患儿预后的价值  

Prognostic value of medium granulocyte count/lymphocyte count combined with blood biochemical indexes in critically ill children with adenovirus pneumonia

作　　者：侯伟 张丽君[1] 张曼[1] 王亚坤[1] 闫智慧 田利远[1] HOU Wei;ZHANG Li-jun;ZHANG Man;WANG Ya-kun;YAN Zhi-hui;TIAN Li-yuan(First Department of Respiration Medicine,Hebei Children's Hospital,Shijiazhuang,Hebei 050031,China)

机构地区：[1]河北省儿童医院呼吸一科,河北石家庄050031

出　　处：《中国卫生检验杂志》2023年第12期1468-1472,共5页Chinese Journal of Health Laboratory Technology

基　　金：白求恩·中青年医生优才培养计划项目(BCF-SY-0311-20190807-01)。

摘　　要：目的探讨中性粒细胞计数与淋巴细胞计数比值(NLR)联合血生化指标预测儿童危重症腺病毒肺炎预后的能力。方法回顾性分析2018年1月—2022年6月河北省儿童医院住院诊断危重症腺病毒肺炎患儿69例。结果69例患儿中12例(17.4%)病死,57例(82.6%)治愈。病死组与治愈组相比,入PICU治疗时NLR值、血白蛋白值、血谷草转氨酶值,血乳氨酸脱氢酶值差异有统计学意义(P<0.05)。危重症腺病毒肺炎患儿NLR值与血乳酸脱氢酶值成正相关(r=0.266,P<0.05),与白蛋白值成负相关(r=-0.332,P<0.01)。多因素logistic回归分析结果显示NLR是患儿病死的独立危险因素。绘制ROC曲线结果显示NLR用于判断预后的曲线下面积为0.938,以最佳截断值2.945判断病死率,其敏感度为0.982,特异度为0.750。以NLR最佳截断值绘制Kaplan-Meier生存曲线显示,NLR高于临界值(>2.945)患儿病死率高于NLR低于临界值(≤2.945)患儿(log-rank=56.587,P=0.000)。结论NLR联合血生化指标对判断危重症腺病毒肺炎患儿预后有重要价值,值得临床关注。Objective This paper aims to investigate the ability of medium granulocyte count/lymphocyte count(NLR)combined with blood biochemical indexes in predicting the prognosis of critically ill children with adenovirus pneumonia.Methods A total of 69 children with critical adenovirus pneumonia who were hospitalized in Hebei Children's Hospital from January 2018 to June 2022 were retrospectively analyzed.Results Among 69 children,12 cases(17.4%)deceased and 57 cases(82.6%)were cured.At the beginning of PICU treatment,there is statistical significance on the differences in NLR,albumin,aspartate aminotransferase,and lactic dehydrogenase between the death group and the cured group(P<0.05).NLR was positively correlated with lactic dehydrogenase(r=0.266,P<0.05)and negatively correlated with albumin(r=-0.332,P<0.01).Multivariate logistic regression analysis showed that NLR was an independent risk factor for death.The ROC curve showed that the area under the curve for NLR was 0.938,and the optimal cut-off value was 2.945 to deter⁃mine the mortality rate.The sensitivity was 0.982,and the specificity was 0.750.The Kaplan-Meier survival curve based on the best cut-off value of NLR showed that the mortality rate of children with NLR higher than the cut-off value(>2.945)was significantly higher than that of children with NLR lower than the cut-off value(≤2.945)(log-rank=56.587,P=0.000).Conclusion NLR combined with blood biochemical indexes has important value in predicting the prognosis of children with critically ill adenovirus pneumonia,which is worthy of clinical attention.

关 键 词：中性粒细胞计数与淋巴细胞计数比值 生化指标 儿童 腺病毒肺炎 危重症 预后 

分 类 号：R725.6[医药卫生—儿科]