中性粒细胞与淋巴细胞比值在预测重症手足口病患者死亡风险中的预后价值
Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Predicting Death Risk in Patients with Severe Hand, Foot and Mouth Disease.
作者信息
Li Yaping, Wang Muqi, Wang Wenjun, Feng Dandan, Deng Huiling, Zhang Yufeng, Dang Shuangsuo, Zhai Song
机构信息
Department of Infectious Diseases, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an 710004, People's Republic of China.
Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an 710003, People's Republic of China.
出版信息
Ther Clin Risk Manag. 2020 Oct 23;16:1023-1029. doi: 10.2147/TCRM.S268130. eCollection 2020.
INTRODUCTION
Severe hand, foot, and mouth disease (HFMD) may lead to serious complications, which cause child mortality during outbreaks. The aim of this study was to determine whether neutrophil-to-lymphocyte ratio (NLR) can predict death risk in severe HFMD.
METHODS
Medical records for 664 severe HFMD patients were retrospectively examined, and NLR was calculated from blood counts. Youden's index was calculated to determine the optimal NLR cutoff. Uni- and multivariate logistic regression were used to determine death risk factors associated with severe HFMD.
RESULTS
An NLR cutoff value of 2.01 and 2.50 respectively predicted mortality among all 664 severe HFMD and 137 critical HFMD. Among all 664 patients, the multivariate model identified the following as independently associated with death risk: high fever (OR 3.342, 95% CI 1.736-6.432), EV71 infection (OR 3.200, 95% CI 1.529-6.698), fasting glucose (OR 37.343, 95% CI 18.616-74.909), and NLR (>2.01) (OR 2.142, 95% CI 1.125-4.079). Among 137 critical HFMD, EV71 infection (OR 3.441, 95% CI 1.132-10.462), fasting glucose (OR 14.173, 95% CI 4.920-40.827), and NLR (>2.50) (OR 4.166, 95% CI 1.570-11.051) were associated with death risk.
CONCLUSION
In conclusion, NLR (>2.01) in severe HFMD and NLR (>2.50) in critical HFMD patients may be associated with increased death risk.
引言
重症手足口病（HFMD）可能导致严重并发症，在疫情暴发期间可导致儿童死亡。本研究的目的是确定中性粒细胞与淋巴细胞比值（NLR）是否可预测重症手足口病的死亡风险。
方法
回顾性分析664例重症手足口病患者的病历，并根据血常规计算NLR。计算约登指数以确定最佳NLR临界值。采用单因素和多因素逻辑回归分析确定与重症手足口病相关的死亡风险因素。
结果
NLR临界值分别为2.01和2.50时，可分别预测664例所有重症手足口病患者及137例危重症手足口病患者的死亡率。在所有664例患者中，多因素模型确定以下因素与死亡风险独立相关：高热（比值比[OR] 3.342，95%置信区间[CI] 1.736 - 6.432）、肠道病毒71型（EV71）感染（OR 3.200，95% CI 1.529 - 6.698）、空腹血糖（OR 37.343，95% CI 18.616 - 74.909）以及NLR（>2.01）（OR 2.142，95% CI 1.125 - 4.079）。在137例危重症手足口病患者中，EV71感染（OR 3.441，95% CI 1.132 - 10.462）、空腹血糖（OR 14.173，95% CI 4.920 - 40.827）以及NLR（>2.50）（OR 4.166，95% CI 1.570 - 11.051）与死亡风险相关。
结论
总之，重症手足口病患者的NLR（>2.01）以及危重症手足口病患者的NLR（>2.50）可能与死亡风险增加相关。
Zotero 插件