新生儿肺炎LAC/ScvO_(2)和NLR与MPV水平及其对并发脓毒症的预测价值  

LAC/ScvO_(2), NLR and MPV in neonates with pneumonia and predictive value for concurrent sepsis

作　　者：陈团营[1] 周雪 王晓利[1] 任玉梅[1] 吴文先[3] CHEN Tuan-ying;ZHOU Xue;WANG Xiao-li;REN Yu-mei;WU Wen-xian(Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou,Henan 450002,China)

机构地区：[1]河南省中医院儿科,河南郑州450002 [2]河南中医药大学研究生院,河南郑州450046 [3]河南省中医药研究院儿科,河南郑州450004

出　　处：《中华医院感染学杂志》2023年第20期3142-3145,共4页Chinese Journal of Nosocomiology

基　　金：河南省中医药科学研究专项基金资助项目(2019ZY2042)。

摘　　要：目的探讨肺炎新生儿乳酸与中心静脉血氧饱和度的比值(LAC/ScvO_(2))和中性粒细胞与淋巴细胞比值(NLR)与血小板平均体积(MPV)及其并发脓毒症预测价值。方法选取2020年6月-2022年6月河南省中医院收治的102例新生儿肺炎患儿,根据是否发生脓毒症分为脓毒症组(n=25)、非脓毒症组(n=77);比较两组基线资料、LAC/ScvO_(2)、NLR、MPV水平,应用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析各指标单独及联合预测肺炎新生儿并发脓毒症的效能,并比较不同LAC/ScvO_(2)、NLR、MPV水平者脓毒症发生率。结果脓毒症组1 min Apgar评分、早产、喂养方式与非脓毒症组比较,差异有统计学意义(P<0.05);脓毒症组LAC/ScvO_(2)、NLR、MPV高于非脓毒症组(P<0.05);LAC/ScvO_(2)、NLR、MPV预测脓毒症风险的AUC分别为0.845(敏感度84.00%,特异度74.03%)、0.809(敏感度68.00%,特异度76.62%)、0.742(敏感度84.00%,特异度63.64%),LAC/ScvO_(2)、NLR联合MPV预测脓毒症发生风险的AUC为0.889(敏感度88.00%,特异度76.62%);LAC/ScvO_(2)、NLR、MPV高水平者脓毒症发生率高于低水平者(P<0.05)。结论肺炎并发脓毒症新生儿LAC/ScvO_(2)、NLR、MPV水平较高,三者联合检测可预测脓毒症具有较高诊断价值。OBJECTIVE To investigate the lactic acid/central venous oxygen saturation(LAC/ScvO_(2)), neutrophil to lymphocyte ratio(NLR), and mean platelet volume(MPV) in newborns with pneumonia, and their predictive value for concurrent sepsis. METHODS A total of 102 children with neonatal pneumonia admitted to Henan Provincial Hospital of Traditional Chinese Medicine from Jun.2020 to Jun.2022 were selected and divided into sepsis group(n=25) and non-sepsis group(n=77) according to whether sepsis occurred.The baseline data, LAC/ScvO_(2), NLR, and MPV levels between the two groups were compared, the efficacy of each index alone and in combination in predicting sepsis in neonates with pneumonia was analyzed by applying the receiver operating characteristic curve(ROC) and the area under the curve(AUC), and the incidence of sepsis was compared between those with different LAC/ScvO_(2), NLR, and MPV levels. RESULTS The 1 minute Apgar score, preterm delivery, and feeding method in the sepsis group were statistically different from those of the non-sepsis group(P<0.05). LAC/ScvO_(2), NLR, MPV of the sepsis group were higher than those of the non-sepsis group(P<0.05). The AUC of LAC/ScvO_(2), NLR, and MPV for predicting the risk of sepsis was 0.845(sensitivity 84.00%, specificity 74.03%), 0.809(sensitivity 68.00%, specificity 76.62%), and 0.742(sensitivity 84.00%, specificity 63.64%), respectively.The AUC of LAC/ScvO_(2), NLR combined with MPV for predicting the risk of sepsis was 0.889(sensitivity 88.00%, specificity 76.62%). The incidence of sepsis was higher in patients with high levels of LAC/ScvO_(2), NLR, and MPV than in those with low levels(P<0.05). CONCLUSION The levels of LAC/ScvO_(2), NLR, and MPV in neonates with pneumonia complicated by sepsis were relatively high, and the combined detection of the three had a diagnostic value in predicting sepsis.

关 键 词：乳酸与中心静脉血氧饱和度的比值 中性粒细胞与淋巴细胞比值 血小板平均体积 新生儿肺炎 脓毒症 

分 类 号：R563.1[医药卫生—呼吸系统]