摘要
【目的】探讨中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(CRP)联合检测对儿童大叶性肺炎预后的预测价值。【方法】回顾性分析2021年1月至2023年8月南阳巿南召县康养中等职业学校附属医院收治的83例大叶性肺炎患儿的临床资料,根据患儿病情严重程度将其分为轻度组(n=27)、中度组(n=39)和重度组(n=17),比较三组患儿NLR、CRP水平,采用Spearman法分析NLR、CRP水平与患儿病情严重程度的相关性。根据患儿预后情况将其分为预后良好组(n=61)和预后不良组(n=22),比较不同预后患儿的临床特征,采用受试者工作特征(ROC)曲线分析NLR和CRP水平对患儿预后的预测价值。【结果】重度组、中度组患儿NLR、CRP水平均高于轻度组患儿,重度组患儿高于中度组患儿,差异有统计学意义(P<0.05)。Spearman相关性分析显示,大叶性肺炎患儿NLR、CRP水平与疾病严重程度呈正相关(r_(s)=0.712、0.766,均P<0.001)。预后不良组和预后良好组患儿胸腔积液占比及白细胞计数、NLR、CRP比较,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,胸腔积液、NLR、CRP均是影响大叶性肺炎患儿预后不良的影响因素(P<0.05)。ROC曲线分析显示,NLR、CRP水平预测大叶性肺炎患儿预后不良的曲线下面积(AUC)分别为0.785、0.808,二者联合的特异度和AUC分别为93.44%、0.873。【结论】NLR、CRP水平与大叶性肺炎患儿疾病严重程度呈正相关,且NLR、CRP是影响患儿预后的相关因素,联合检测可有效预测患儿预后。
【Objective】To explore the value of combined detection of serum C-reactive protein(CRP)and neutrophil/lymphocyte ratio(NLR)in assessing the severity and prognosis of pediatric lobular pneumonia.【Methods】A total of 83 children with lobular pneumonia admitted to our hospital from August 2020 to April 2023 were included in the study.According to the severity of the disease condition,patients were divided into the mild(31 cases),moderate(45 cases),and severe(19 cases)groups.The CRP and NLR levels of the three groups were measured,and Spearman correlation analysis was conducted to assess the relationship of disease severity with CRP and NLR levels.Based on prognosis,the patients were divided into a good prognosis group(70 cases)and a poor prognosis group(25 cases).Logistic regression was used to analyze the risk factors for poor prognosis,and a receiver operating characteristic(ROC)curve was constructed to evaluate the predictive value of combined serum CRP and NLR levels for prognosis.【Results】The levels of CRP and NLR in the severe group were significantly higher than those in the moderate and mild groups,and the level of CRP and NLR in the moderate group showed higher level than that in the mild group(P<0.05).Correlation analysis indicated a positive correlation between the severity of the disease and serum levels of CRP and NLR(r_(s)=0.712、0.766,all P<0.001).There were significant differences in the proportion of pleural effusion,white blood cell count,NLR,and CRP between the poor prognosis group and the good prognosis group(P<0.05).Logistic multivariate analysis revealed that the presence of pleural effusion,elevated CRP level and high NLR level were independent risk factors for poor prognosis(P<0.05).ROC curve analysis showed that the areas under the curve(AUC)of NLR and CRP levels for predicting the poor prognosis of children with lobar pneumonia were 0.785 and 0.808,respectively,and the specificity and AUC of the combination of the two were 93.44%and 0.873,respectively.【Conclusion】Serum levels of CRP and NLR are effective in assessing the severity and prognosis of pediatric lobular pneumonia.The combined detection of both markers provides high sensitivity and specificity for predicting poor prognosis.
作者
任昶
牛银萍
秦小苑
REN Chang;NIU Yinping;QIN Xiaoyuan(Department of Pediatrics,Affiliated Hospital of Kangyang Secondary Vocational School,Nanzhao County,Nanyang Henan 474650)
出处
《医学临床研究》
2025年第3期456-459,共4页
Journal of Clinical Research
