NPAR对肺炎新生儿并发败血症的预测价值  

The predictive value of neutrophil percentage-to-albumin ratio in neonatal pneumonia complicated with sepsis

作　　者：李晓娟 岳保红[3] 李铁威[2] Li Xiaojuan;Yue Baohong;Li Tiewei(School of Basic Medical Sciences,Zhengzhou University,Zhengzhou 450001,China;Department of Clinical Laboratory,Henan Children′s Hospital,Children′s Hospital Affiliated of Zhengzhou University,Zhengzhou 450018,China;Department of Clinical Laboratory,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450018,China)

机构地区：[1]郑州大学基础医学院,郑州450001 [2]河南省儿童医院,郑州大学附属儿童医院检验科,郑州450018 [3]郑州大学第一附属医院检验科,郑州450018

出　　处：《国际呼吸杂志》2024年第3期336-342,共7页International Journal of Respiration

基　　金：国家自然科学基金(82200097);河南省科技攻关项目(232102310122)。

摘　　要：目的探讨中性粒细胞百分比与白蛋白比值(NPAR)对肺炎新生儿并发败血症的预测价值。方法本研究为病例对照研究,采用非随机抽样的方法纳入2018年1月至2022年7月于河南省儿童医院住院治疗的1969例新生儿肺炎患儿为研究对象。根据住院期间是否合并新生儿败血症将患儿分为败血症组(690例)和无败血症组(1279例)。比较2组患儿入院时的一般资料(性别、日龄、体重、体温、呼吸频率、心率和入院前病程)和入院首次检测的实验室指标[白细胞计数、中性粒细胞计数、中性粒细胞百分比、白蛋白(ALB)、丙氨酸转氨酶、天冬氨酸转氨酶和NPAR]。采用Spearman秩相关分析评估NPAR与其他临床和实验室指标之间的相关性。通过logistic回归分析肺炎新生儿并发败血症的影响因素。受试者操作特征曲线分析NPAR、中性粒细胞百分比和ALB对新生儿肺炎合并败血症的预测价值。结果2组患儿性别、日龄、呼吸频率和入院前病程比较差异均无统计学意义(均P>0.05)。败血症组患儿入院时的体重低于无败血症组[(3.08±0.80)kg比(3.34±0.63)kg,t=7.81,P<0.05],体温、心率高于无败血症组[(37.3±0.9)℃比(37.0±0.5)℃,(151.9±19.3)次/min比(148.1±16.0)次/min,均P<0.05]。败血症组患儿白细胞计数、中性粒细胞计数、中性粒细胞百分比和NPAR均高于无败血症组[10.15(7.26,14.66)×10^(9)/L比9.69(7.84,11.91)×10^(9)/L,5.18(3.07,8.94)×10^(9)/L比3.77(2.69,5.41)×10^(9)/L,54.40(40.17,68.10)%比41.00(31.60,50.80)%,1.79(1.28,2.37)比1.23(0.92,1.62),均P<0.05],ALB低于无败血症组[(29.9±5.1)g/L比(33.5±8.9)g/L,t=9.89,P<0.05]。Spearman秩相关分析显示,NPAR与日龄、体重呈负相关(r值分别为-0.249、-0.180),与呼吸频率、心率和白细胞计数呈正相关(r值分别为0.084、0.069、0.209)。多因素logistic回归分析显示体温、NPAR升高是肺炎新生儿合并败血症的独立危险因素(OR=2.647,95%CI:2.184~3.209;OR=ObjectiveTo explore the predictive value of neutrophil percentage-to-albumin ratio(NPAR)in neonatal pneumonia complicated with sepsis.MethodsThis study was a case-control study.A total of 1,969 neonates with pneumonia hospitalized in Henan Children′s Hospital from January 2018 to July 2022 were enrolled using a non-random sampling method.Enrolled neonates were divided into sepsis group(690 cases)and non-sepsis group(1,279 cases)based on whether they were diagnosed with sepsis during hospitalization.Baseline characteristics,including gender,age,body weight,body temperature,respiratory rate,heart rate,and pre-admission course of illness,as well as the initial laboratory indicators after admission,including white blood cell count(WBC),neutrophil count(NE),percentage of neutrophils(NE%),albumin(ALB),alanine transaminase,aspartate transaminase and NPAR were compared.Spearman rank correlation analysis was used to evaluate the correlations of NPAR with other clinical and laboratory indicators.Logistic regression analysis was used to identify the independent risk factors for sepsis in neonates with pneumonia.Receiver operator characteristic(ROC)curve was used to evaluate the predictive value of NPAR,NE%and ALB in discriminating neonatal pneumonia complicated with sepsis or not.ResultsThere were no significant differences in gender,age,respiratory rate,and pre-admission course of illness between groups(all P>0.05).Neonates with pneumonia in the sepsis group had significantly lower body weight on admission([3.08±0.80]kg vs[3.34±0.63]kg),but higher body temperature([37.3±0.9]℃vs[37.0±0.5]℃)and heart rate([151.9±19.3]bpm vs[148.1±16.0]bpm)than those of the non-sepsis group(all P<0.05).Compared with those in the non-sepsis group,neonates with pneumonia in the sepsis group had significantly higher WBC(10.15[7.26,14.66]×10^(9)/L vs 9.69[7.84,11.91]×10^(9)/L),NE(5.18[3.07,8.94]×10^(9)/L vs 3.77[2.69,5.41]×10^(9)/L),NE%(54.40[40.17,68.10]%vs 41.00[31.60,50.80]%),and NPAR(1.79[1.28,2.37]vs 1.23[0.92,1.62]),but lowe

关 键 词：新生儿脓毒症 肺炎 婴儿 新生 中性粒细胞百分比与白蛋白比值 

分 类 号：R722.1[医药卫生—儿科]