Abrol Ritika, Ahmed Sohaib, Khanduri Rakhee
Department of General Medicine, Himalayan Institute of Medical Sciences, Himalayan Institute of Medical Sciences, Jolly Grant, Uttarakhand, India.
J Family Med Prim Care. 2024 Aug;13(8):3179-3183. doi: 10.4103/jfmpc.jfmpc_1940_23. Epub 2024 Jul 26.
To determine the diagnostic potential of neutrophil-to-lymphocyte ratio (NLR) as a POC marker to discriminate tuberculous from non-tuberculous CAP and identify limitations if any at a tertiary care centre in Uttarakhand, India.
225 patients presenting with respiratory complaints were recruited from the General Medicine clinics and investigated. NLR was noted at onset and correlated with final diagnosis.
NLR from both groups did not exhibit a statistically significant difference. The area under curve (AUC) exhibited an accuracy of 49.1% in differentiating tuberculous from non-tubercular CAP, and an anomalous effect of prior steroid exposure on NLR was noted as a limitation.
The disparity of our results from previous studies warranted a review of literature which rendered a significant limitation of NLR. The NLR is affected by catecholamines, which makes the marker unreliable in patients with exogenous steroid exposure. This was not noted in the previous studies. We presume indiscriminate steroid usage in the pandemic confounded our findings. We propose that this limitation be accounted for in future studies so that NLR's true utility may be identified.
在印度北阿坎德邦的一家三级医疗中心，确定中性粒细胞与淋巴细胞比值（NLR）作为即时检测指标以区分结核性与非结核性社区获得性肺炎（CAP）的诊断潜力，并识别其存在的局限性（如有）。
从普通内科门诊招募225例有呼吸道症状的患者进行调查。记录发病时的NLR，并与最终诊断结果进行关联分析。
两组的NLR无统计学显著差异。曲线下面积（AUC）在区分结核性与非结核性CAP时的准确率为49.1%，并且发现既往使用类固醇对NLR有异常影响，这是一个局限性。
我们的结果与先前研究存在差异，因此有必要对文献进行回顾，这揭示了NLR存在重大局限性。NLR受儿茶酚胺影响，这使得该指标在外源性类固醇暴露患者中不可靠。先前的研究未注意到这一点。我们推测在疫情期间类固醇的滥用混淆了我们的研究结果。我们建议在未来的研究中考虑这一局限性，以便确定NLR的真正效用。
