Panda Santosh K, Nayak Manas K, Rath Soumini, Das Palash
Pediatric Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, IND.
Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneshwar, IND.
Cureus. 2021 Jan 24;13(1):e12891. doi: 10.7759/cureus.12891.
Aim To find the diagnostic utility of the neutrophil to lymphocyte ratio (NLR) in the early diagnosis of neonatal sepsis. Methodology The case records of all blood culture-positive septic neonates admitted from January 2018 to December 2018 were reviewed. Total leucocyte count, absolute neutrophil count, absolute lymphocyte counts, NLR, and C-reactive protein (CRP) of septic neonates were compared with gestational age-matched nonseptic neonates by an unpaired t-test. The diagnostic performance of NLR and CRP was analyzed by receiver operating characteristic (ROC) analysis. Result A total of 41 blood culture-positive neonates and 52 nonseptic neonates were enrolled in this study. There was no significant difference in the total leucocyte count and absolute neutrophil counts of septic and nonseptic neonates. The mean absolute lymphocyte count of septic neonates (2795±1424/cumm) was significantly lower than that of nonseptic neonates (4449±1794/cumm; p=<0.001). The mean NLR of septic neonates (3.88±1.78) was significantly higher as compared to nonseptic (2.3404 ±1.98) neonates (p=0.045). For the diagnosis of sepsis, NLR at cutoff >1.7 had a sensitivity and specificity of 68.3% and 46.2%, respectively; CRP at cutoff >6 mg/dl had sensitivity and specificity of 78.05% and 92.31%, respectively. In the ROC analysis, the area under the curve (AUC) for CRP and NLR for the diagnosis of neonatal sepsis was 0.918 (p=<0.001) and 0.623 (p=0.042), respectively. Conclusion Blood culture-positive septic neonates had significantly higher NLR as compared to nonseptic neonates. However, when compared to CRP, NLR was not found to be a better predictor of sepsis in our study.
目的 探讨中性粒细胞与淋巴细胞比值（NLR）在新生儿败血症早期诊断中的应用价值。方法 回顾性分析2018年1月至2018年12月期间所有血培养阳性的败血症新生儿的病历资料。采用非配对t检验，将败血症新生儿的白细胞总数、中性粒细胞绝对值、淋巴细胞绝对值、NLR及C反应蛋白（CRP）与孕周匹配的非败血症新生儿进行比较。通过受试者工作特征（ROC）分析评估NLR和CRP的诊断性能。结果 本研究共纳入41例血培养阳性的新生儿和52例非败血症新生儿。败血症新生儿与非败血症新生儿的白细胞总数和中性粒细胞绝对值无显著差异。败血症新生儿的平均淋巴细胞绝对值（2795±1424/立方毫米）显著低于非败血症新生儿（4449±1794/立方毫米；p<0.001）。败血症新生儿的平均NLR（3.88±1.78）显著高于非败血症新生儿（2.3404±1.98）（p=0.045）。对于败血症的诊断，NLR临界值>1.7时，灵敏度和特异度分别为68.3%和46.2%；CRP临界值>6毫克/分升时，灵敏度和特异度分别为78.05%和92.31%。在ROC分析中，CRP和NLR诊断新生儿败血症的曲线下面积（AUC）分别为0.918（p<0.001）和0.623（p=0.042）。结论 血培养阳性的败血症新生儿的NLR显著高于非败血症新生儿。然而，在本研究中，与CRP相比，NLR并不是败血症更好的预测指标。
