Department of Pediatrics, Beiwaitan Community Health Service Center, Hongkou District, Shanghai, China.
Department of General Practice, Beiwaitan Community Health Service Center, Hongkou District, Shanghai, China.
BMC Pediatr. 2023 Dec 18;23(1):640. doi: 10.1186/s12887-023-04456-6.
Compared with a lower neutrophil to lymphocyte ratio(NLR), a higher one denotes severe asthma exacerbation in hospitalized asthmatic children. In addition, NLR is significantly higher in pediatric patients with community-acquired pneumonia (CAP) than those without. Nevertheless, its role in pediatric patients with concomitant asthmatic exacerbation and CAP remains unknown.
In this retrospective study including 1032 pediatric patients aged 5 to 14 years old, the diagnostic and prognostic value of NLR in children with concomitant asthmatic exacerbation and non-severe CAP were investigated.
The sensitivity and specificity of NLR for a diagnosis of CAP in patients with asthmatic exacerbation were 56.9% and 90.1%, respectively. The cutoff value of NLR for a diagnosis of CAP in patients with asthmatic exacerbation was 4.15 (P < 0.001). The cumulative asthmatic exacerbation during 3-month followup of patients with high NLR were 23 (21.3%) and 58 (42.0%) in the asthma and asthmatic CAP groups, respectively (P < 0.001). The patients with high NLR who had unimproved CAP were 15 (8.3%) and 23 (12.2%) in the CAP and asthmatic CAP groups, respectively (P = 0.006). Multivariate analyses showed that along with the increase of NLR by 1.0 point, the HR for the occurrence of asthmatic exacerbation and unimproved CAP were 2.91 [1.83-3.96] (P = 0.001) and 3.38 [1.66-5.10] (P < 0.001), respectively.
NLR had high and moderate diagnostic value for the exclusion and indication of CAP, respectively, in pediatric patients with asthmatic exacerbation. It also had prognostic value for the outcomes of pediatric patients with concomitant asthmatic exacerbation and CAP.
与较低的中性粒细胞与淋巴细胞比值（NLR）相比，较高的 NLR 表示住院哮喘儿童的哮喘加重严重。此外，社区获得性肺炎（CAP）患儿的 NLR 明显高于非 CAP 患儿。然而，其在合并哮喘加重和 CAP 的儿科患者中的作用尚不清楚。
本回顾性研究纳入了 1032 名 5 至 14 岁的儿科患者，研究了 NLR 在合并哮喘加重和非重症 CAP 的儿科患者中的诊断和预后价值。
NLR 对哮喘加重患者 CAP 的诊断的敏感性和特异性分别为 56.9%和 90.1%。哮喘加重患者 NLR 诊断 CAP 的临界值为 4.15（P<0.001）。在 3 个月的随访中，高 NLR 组患者的哮喘加重累积发生率分别为哮喘组的 23（21.3%）和哮喘合并 CAP 组的 58（42.0%）（P<0.001）。NLR 较高且 CAP 未改善的患者中，CAP 组和哮喘合并 CAP 组分别有 15（8.3%）和 23（12.2%）例（P=0.006）。多变量分析显示，NLR 增加 1.0 点，哮喘加重和 CAP 未改善的 HR 分别为 2.91[1.83-3.96]（P=0.001）和 3.38[1.66-5.10]（P<0.001）。
NLR 对哮喘加重患儿 CAP 的排除和指征均具有较高和中度的诊断价值。它对合并哮喘加重和 CAP 的儿科患者的预后也具有预测价值。
