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外周血参数对新生儿肺炎的诊断价值评估

Evaluation of the Diagnostic Value of Peripheral Blood Parameters for Neonatal Pneumonia.

作者信息

Liao Dan, Li Jinmi, Lv Jing, Sun Tingting, Deng Shaoli

出版信息

Clin Lab. 2020 Nov 1;66(11). doi: 10.7754/Clin.Lab.2020.200407.

Abstract

BACKGROUND

To evaluate the diagnostic value of peripheral blood parameters including white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, mean platelet volume (MPV), platelet distribution width (PDW), mean corpuscular volume (MCV), red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte ratio (PLR) and platelet-to-neutrophil ratio (PNR) for neonatal pneumonia.

METHODS

Two hundred and six full-term neonates in our hospital from January 2018 to December 2019 were enrolled, including 73 pneumonic neonates and 133 health controls. Peripheral blood parameters were measured by an automatic blood cell analyzer. While C-reactive protein (CRP) and PCT concentrations were detected by electrochemical luminescence assay. Clinical signs, characteristic population, temperature, and chest radiograph findings were recorded. The receiver operating characteristic (ROC) curve was used to determine the cutoff values and analyze the diagnosis significances for neonatal pneumonia.

RESULTS

This study showed that WBC, neutrophil, RDW, NLR, and MLR levels in the pneumonic group were higher than that of the control group, whereas lymphocyte, monocyte, platelet, and PNR levels were lower (p < 0.05). The ROC curve result showed that NLR and PNR owned higher AUC values than the rest of peripheral blood variables. At a cutoff value 2.581, NLR exhibited 63.01% sensitivity, 90.98% specificity, and 0.847 area under ROC curve (AUC). In addition, at a cutoff value 52.77, PNR showed 84.93% sensitivity, 78.95% specificity, and 0.856 AUC.

CONCLUSIONS

This study clarifies that peripheral blood parameter of NLR and PNR have good applied value in diagnosis neonatal pneumonia with high sensitivity and specificity.

摘要

背景

评估外周血参数,包括白细胞(WBC)、中性粒细胞、淋巴细胞、单核细胞、血小板、平均血小板体积(MPV)、血小板分布宽度(PDW)、平均红细胞体积(MCV)、红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)以及血小板与中性粒细胞比值(PNR)对新生儿肺炎的诊断价值。

方法

纳入我院2018年1月至2019年12月的206例足月新生儿,其中肺炎新生儿73例,健康对照133例。采用自动血细胞分析仪检测外周血参数。同时采用电化学发光法检测C反应蛋白(CRP)和降钙素原(PCT)浓度。记录临床症状、特征人群、体温及胸部X线检查结果。采用受试者操作特征(ROC)曲线确定临界值并分析外周血参数对新生儿肺炎的诊断意义。

结果

本研究显示,肺炎组的WBC、中性粒细胞、RDW、NLR和MLR水平高于对照组,而淋巴细胞、单核细胞、血小板和PNR水平较低(p<0.05)。ROC曲线结果显示,NLR和PNR的曲线下面积(AUC)值高于其他外周血变量。在临界值为2.581时,NLR的灵敏度为63.01%,特异度为90.98%,ROC曲线下面积(AUC)为0.847。此外,在临界值为52.77时,PNR的灵敏度为84.93%,特异度为78.95%,AUC为0.856。

结论

本研究表明,外周血参数NLR和PNR在新生儿肺炎诊断中具有较高的灵敏度和特异度,具有良好的应用价值。

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