血常规衍生炎症指标对重症腺病毒肺炎患儿并发闭塞性细支气管炎的预测价值  

Predictive Value of Blood Routine Derived Inflammation Indexes for Bronchiolitis Obliterated in Children with Severe Adenovirus Pneumonia

作　　者：侯伟 李清涛[1] 王亚坤[1] 张曼[1] 张丽君[1] 田利远[1] HOU Wei;LI Qingtao;WANG Yakun;ZHANG Man;ZHANG Lijun;TIAN Liyuan(Department of Respiratory Science,Hebei Children's Hospital,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院呼吸一科,河北省石家庄市050031

出　　处：《实用心脑肺血管病杂志》2024年第10期59-63,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：河北省医学科学研究课题计划项目(20211014)。

摘　　要：目的探讨血常规衍生炎症指标对重症腺病毒肺炎(SAP)患儿并发闭塞性细支气管炎(BO)的预测价值。方法回顾性选取2019—2023年河北省儿童医院收治的77例SAP患儿为研究对象。收集患儿临床资料,包括一般资料、临床表现、7型腺病毒感染情况、入院时实验室检查指标,并计算入院时、治疗1周时中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、系统免疫炎症指数(SII)。根据BO发生情况将患儿分为BO组26例和非BO组51例。采用多因素Logistic回归分析探讨SAP患儿并发BO的影响因素;采用ROC曲线分析发热时间、治疗1周时NLR预测SAP患儿并发BO的价值。结果两组混合感染发生率、发热时间比较,差异有统计学意义(P<0.05)。治疗1周时BO组NLR、PLR、SII高于非BO组(P<0.05)。BO组治疗1周时NLR、SII高于入院时(P<0.05)。非BO组治疗1周时PLR低于入院时(P<0.05)。多因素Logistic回归分析结果显示,发热时间〔OR=1.155,95%CI(1.099~1.322)〕、治疗1周时NLR〔OR=4.334,95%CI(1.491~12.600)〕是SAP患儿并发BO的独立影响因素(P<0.05)。ROC曲线分析结果显示,发热时间预测SAP患儿并发BO的AUC为0.809〔95%CI(0.702~0.916)〕,最佳截断值为16 d,灵敏度为65.4%,特异度为86.3%。治疗1周时NLR预测SAP患儿并发BO的AUC为0.807〔95%CI(0.712~0.902)〕,最佳截断值为1.85,灵敏度为96.2%,特异度为64.7%。结论治疗1周时NLR是SAP患儿并发BO的独立影响因素,且其对SAP患儿并发BO有一定预测价值。Objective To explore the predictive value of blood routine derived inflammation indexes for bronchiolitis obliterans(BO)in children with severe adenovirus pneumonia(SAP).Methods A total of 77 children with SAP admitted to Heibei Children's Hospital from 2019 to 2023 were retrospectively selected as research subjects.The clinical data including general information,clinical feature,adenovirus type 7 infection,and laboratory indicators at admission were collected.Neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and systemic immune-inflammation index(SII)at admission,1 week of treatment were calculated.The children were divided into BO group(n=26)and non-BO group(n=51)according to the occurrence of BO.Multivariate Logistic regression analysis was used to explore the influencing factors of BO in children with SAP.ROC curve was used to explore the predictive value of fever duration and NLR at 1 week of treatment for BO in children with SAP.Results There were significant differences in the incidence of mixed infection and fever duration between the two groups(P<0.05).The NLR,PLR,and SII of the BO group were higher than those of the non-BO group at 1 week of treatment(P<0.05).The NLR and SII of the BO group at 1 week of treatment were higher than those at admission(P<0.05);the PLR of the non-BO group at 1 week of treatment was lower than that at admission(P<0.05).Multivariate Logistic regression analysis showed that fever duration[OR=1.155,95%CI(1.099-1.322)]and NLR at 1 week of treatment[OR=4.334,95%CI(1.491-12.600)]were independent influencing factors for BO in children with SAP(P<0.05).ROC curves analysis showed that the AUC of fever duration in predicting in children with SAP was 0.809[95%CI(0.702-0.916)],the best cut-off value was 16 d,the sensitivity was 65.4%,and the specificity was 86.3%.The AUC of NLR at 1 week of treatment in predicting BO in children with SAP was 0.807[95%CI(0.712-0.902)],the best cut-off value was 1.85,the sensitivity was 96.2%,and the specificity was 64.7%.Conclusion NLR

关 键 词：腺病毒感染 人 闭塞性细支气管炎 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 系统免疫炎症指数 

分 类 号：R511.8[医药卫生—内科学] R562.21[医药卫生—临床医学]