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简单的血液学标志物在预测新生儿暂时性呼吸急促的严重程度中的应用:旧瓶装新酒。

Simple Hematological Markers in Predicting the Severity of Transient Tachypnea of Newborn: New Wine in Old Bottles.

机构信息

Faculty of Medicine, Department of Pediatrics, Istinye University, Istanbul 34899, Turkey.

Perinatalogy Unit, Zeynep Kamil Women and Children's Training and Research Hospital, University of Health Sciences, Istanbul 34668, Turkey.

出版信息

J Trop Pediatr. 2021 Dec 8;67(6). doi: 10.1093/tropej/fmab100.

Abstract

OBJECTIVES

To evaluate the validity of red cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet mass index (PMI) of patients with transient tachypnea of the newborn (TTN), and to find out their roles in predicting severity of TTN.

PATIENTS AND METHODS

In this prospective study, hematological parameters (RDW, PMI) and ratios (NLR, PLR) of 147 patients with TTN and 147 full-term healthy controls were evaluated and compared at birth and at 72nd h of life.

PATIENT

s with TTN and 147 full-term healthy controls were evaluated and compared at birth and at 72nd hours of life.

RESULTS

RDW and NLR were not only significantly higher in patients with TTN at birth (p = 0.001) and at 72nd hours of life (p: 0.001), but also were correlated with days of nasal continuous positive airway pressure therapy, duration of O2 therapy, TTN clinical scores, hospitalization and TTN duration. At a cut-off value of 2.40, NLR had a sensitivity of 82.5% and specificity of 77.5% to predict TTN, the most striking parameter at 72nd hours of life. RDW of 17.75 was also determined as the predictive cutoff value of TTN (sensitivity 72.5%; specificity 67.5%; area under the receiver-operating characteristic curve 0.80; p = 0.001). Multivariate analysis model adjusted for delivery, gestational age, male gender revealed that RDW and NLR were significantly and independently associated with TTN.

CONCLUSION

RDW and NLR both at birth and at 72nd hours of life can be used as biomarkers to distinguish TTN patients from healthy newborns and to predict the severity of TTN.

摘要

目的

评估红细胞分布宽度(RDW)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)和血小板质量指数(PMI)对新生儿短暂性呼吸急促(TTN)患者的有效性,并确定它们在预测 TTN 严重程度中的作用。

方法

在这项前瞻性研究中,对 147 例 TTN 患者和 147 例足月健康对照者在出生时和生后 72 小时进行了血液学参数(RDW、PMI)和比值(NLR、PLR)评估和比较。

结果

RDW 和 NLR 在 TTN 患者出生时(p = 0.001)和生后 72 小时(p < 0.001)均显著升高,且与经鼻持续气道正压通气治疗天数、氧疗时间、TTN 临床评分、住院时间和 TTN 持续时间相关。在截断值为 2.40 时,NLR 对 TTN 的预测敏感性为 82.5%,特异性为 77.5%,是生后 72 小时最显著的参数。RDW 为 17.75 也被确定为 TTN 的预测截断值(敏感性 72.5%;特异性 67.5%;ROC 曲线下面积 0.80;p = 0.001)。调整分娩、胎龄、男性等因素的多变量分析模型表明,RDW 和 NLR 与 TTN 显著相关。

结论

RDW 和 NLR 在出生时和生后 72 小时均可作为生物标志物,用于区分 TTN 患者与健康新生儿,并预测 TTN 的严重程度。

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