Silva Paulo Sérgio Lucas, Iglesias Simone Brasil Oliveira, Nakakura Cesar Hiroyuki, de Aguiar Vâania Euzébio, de Carvalho Werther Brunow
Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal de São Paulo, Brazil.
Ann Trop Paediatr. 2007 Mar;27(1):25-30. doi: 10.1179/146532807X170475.
Despite improvement in the treatment of Neisseria meningitidis infection, meningococcal diseases (MD) are still an important cause of morbidity and mortality around the world. This study assessed the performance of the product of platelet and neutrophil counts (PN product) at the time of presentation to hospital as a predictor of outcome in children with MD.
Retrospective evaluation of children with clinical MD admitted to two paediatric intensive care units in Brazil.
Seventy-two children aged 2-156 months were studied. Overall mortality was 19.7%. The PN product, the Glasgow Meningococcal Septicaemia Prognostic Score and the Paediatric Risk of Mortality score discriminated between survivors and non-survivors. A PN < or = 113 had a sensitivity of 28.6% (95% CI 8.6-58.1), specificity of 96.6% (95% CI 88.1-99.5) and positive and negative predictive values of 66.7% and 84.8%. The area under the receiver operating characteristic curve was 0.85 (95% CI 0.74-0.92).
The PN product had a lower performance than reported in previous studies from a developed country. The PN product, however, is a good indicator of mortality in MD but needs to be validated for the population to which it is being applied.
尽管脑膜炎奈瑟菌感染的治疗有所改善，但脑膜炎球菌病（MD）仍是全球发病和死亡的重要原因。本研究评估了入院时血小板与中性粒细胞计数乘积（PN乘积）作为MD患儿预后预测指标的性能。
对巴西两家儿科重症监护病房收治的临床诊断为MD的儿童进行回顾性评估。
研究了72名年龄在2至156个月的儿童。总体死亡率为19.7%。PN乘积、格拉斯哥脑膜炎球菌败血症预后评分和儿科死亡风险评分可区分存活者和非存活者。PN≤113时，敏感性为28.6%（95%CI 8.6 - 58.1），特异性为96.6%（95%CI 88.1 - 99.5），阳性预测值和阴性预测值分别为66.7%和84.8%。受试者工作特征曲线下面积为0.85（95%CI 0.74 - 0.92）。
PN乘积的性能低于发达国家先前研究报告的水平。然而，PN乘积是MD死亡率的一个良好指标，但需要在其应用人群中进行验证。
