CRP/Alb、PLR、Lac与新生儿细菌性脑膜炎预后的关系及其联合预测价值  

Association of CRP/Alb,PLR and Lac with prognosis of neonates with bacterial meningitis and predictive value of joint detection

作　　者：孙晓再[1] 屈晓敏[1] 何红丽[1] 李冬梅[1] 刘丹[1] 张晋雷[2] SUN Xiao-zai;QU Xiao-min;HE Hong-li;LI Dong-mei;LIU Dan;ZHANG Jin-lei(Nanyang Medical College,Nanyang,Henan 473000,China;不详)

机构地区：[1]南阳医学高等专科学校护理系,河南南阳473000 [2]南阳医学高等专科学校第一附属医院儿科一病区,河南南阳473000

出　　处：《中华医院感染学杂志》2023年第14期2165-2169,共5页Chinese Journal of Nosocomiology

基　　金：南阳市科技攻关基金资助项目(2020KJGG131,2019KJGG186)。

摘　　要：目的探讨C-反应蛋白与白蛋白比值(CRP/Alb)、血小板与淋巴细胞比值(PLR)、血乳酸(Lac)与新生儿细菌性脑膜炎预后关系及联合预测价值。方法选取2020年9月-2022年3月南阳医学高等专科学校第一附属医院收治的91例新生儿细菌性脑膜炎患儿为研究对象,治疗10~21 d后根据预后不同分为不良组23例和良好组68例,比较两组基线资料、治疗前与治疗5 d后CRP/Alb、PLR、Lac水平,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析治疗5 d后CRP/Alb、PLR、Lac预测预后价值,并比较不同CRP/Alb、PLR、Lac水平患儿预后情况。结果不良组患儿早产占比与良好组比较,差异有统计学意义(P<0.05);良好组患儿治疗5 d后CRP/Alb、PLR、Lac均低于治疗前(P<0.05),不良组患儿治疗5 d后CRP/Alb、PLR、Lac与治疗前比较,无统计学差异;不良组治疗5 d后CRP/Alb、PLR、Lac高于良好组;CRP/Alb、PLR、Lac预测预后的AUC分别为0.756、0.712、0.691,各指标联合为0.872(P<0.05),预测敏感度为73.91%,特异度为83.82%;CRP/Alb、PLR、Lac高水平患儿预后不良率高于低水平(P<0.05)。结论CRP/Alb、PLR、Lac与新生儿细菌性脑膜炎预后有关,联合检测可作为预测预后的一个有效方案,为临床治疗、决策等提供参考。OBJECTIVE To explore the association of C-reactive protein to albumin ratio(CRP/Alb),platelet to lymphocyte ratio(PLR)and blood lactic acid(Lac)with prognosis of neonates with bacterial meningitis and analyze the predictive value of joint detection of the indexes.METHODS A total of 91neonates with bacterial meningitis who were treated in the First Affiliated Hospital of Nanyang Medical College from Sep 2020to Mar 2022were recruited as the research subjects and were divided into the poor group with 23cases and the good group with 68 cases according to the prognosis after the treatment for 10-21days.The baseline data were compared between the two groups,the CRP/Alb,PLR and Lac level were observed and compared between the two groups before the treatment and after the treatment for 5days.The values of CRP/Alb,PLR and Lac 5days after treatment in prediction of prognosis were analyzed by means of receiver operating characteristic(ROC)curves and area under curve(AUC).The prognosis was compared among the neonates with different CRP/Alb,PLR and Lac levels.RESULTS There was significant difference in the proportion of preterm neonates between the good group and the poor group(P<0.05).The CRP/Alb,PLR and Lac of the good group were significantly lower after the treatment for 5days than before the treatment(P<0.05);there were no significant differences in the CRP/Alb,PLR and Lac of the poor group before the treatment and after the treatment for 5days.The CRP/Alb,PLR and Lac of the poor group were significantly higher than those of the good group after the treatment for 5days.The AUCs of CRP/Alb,PLR and Lac were respectively 0.756,0.712and 0.691in prediction of prognosis,and the AUC of the joint detection of the indexes was 0.872(P<0.05),the sensitivity was 73.91%,and the specificity was 83.82%.The incidence of poor prognosis of the neonates with high CRP/Alb,PLR and Lac level was significantly higher than that of the neonates with low CRP/Alb,PLR and Lac level(P<0.05).CONCLUSION The CRP/Alb,PLR and Lac are associated with the

关 键 词：C-反应蛋白与白蛋白比值 血小板与淋巴细胞比值 血乳酸 新生儿 细菌性脑膜炎 预后 诊断价值 

分 类 号：R722.13[医药卫生—儿科]