Domnicu Alina Emilia, Boia Eugen Radu, Mogoi Mirela, Manea Aniko-Maria, Marcovici Tamara Marcela, Mărginean Otilia, Boia Marioara
Ph.D. School Department, 'Victor Babeş' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania.
Clinical Section I Pediatrics-Nutritional Recovery, Children's Emergency Hospital 'Louis Turcanu', 300011 Timisoara, Romania.
Children (Basel). 2023 Sep 28;10(10):1616. doi: 10.3390/children10101616.
Sepsis represents one of the leading causes of death in newborns and infants, and prompt diagnosis is essential for achieving favorable outcomes. Regarding malnourished children with concurrent infection, most studies have focused, besides blood culture, on C-reactive protein and procalcitonin. Because malnutrition has a deleterious effect on cellular immune competence, the present study characterized the acute-phase response, including hematological indices, in response to sepsis. Among the examined laboratory biomarkers, procalcitonin and neutrophil-to-lymphocyte ratio were the most accurate discriminators between sepsis patients and those with bacterial infection. Moreover, these two parameters showed a gradual increase between sepsis, severe sepsis, and septic shock patients ( < 0.001). Subgroup analysis of the sepsis group revealed positive correlations of NLR with prolonged ICU stay (<0.001), acute organ dysfunction (0.038), mechanical ventilation (<0.001), and fatality (<0.001). In summary, our results suggest that the neutrophil-to-lymphocyte ratio can be used as an auxiliary diagnostic index in discriminating the presence and severity of bacterial sepsis in malnourished infants.
脓毒症是新生儿和婴儿死亡的主要原因之一，及时诊断对于取得良好预后至关重要。对于合并感染的营养不良儿童，除血培养外，大多数研究集中于C反应蛋白和降钙素原。由于营养不良对细胞免疫能力有有害影响，本研究对脓毒症反应的急性期反应进行了表征，包括血液学指标。在所检测的实验室生物标志物中，降钙素原和中性粒细胞与淋巴细胞比值是脓毒症患者和细菌感染患者之间最准确的鉴别指标。此外，这两个参数在脓毒症、严重脓毒症和脓毒性休克患者之间呈逐渐升高趋势（<0.001）。脓毒症组的亚组分析显示中性粒细胞与淋巴细胞比值与ICU住院时间延长（<0.001）、急性器官功能障碍（0.038）、机械通气（<0.001）和死亡率（<0.001）呈正相关。总之，我们的结果表明，中性粒细胞与淋巴细胞比值可作为鉴别营养不良婴儿细菌性脓毒症的存在和严重程度的辅助诊断指标。
