Yin Qigai, Yin Jing, Shen Lu, Zhou Qin, Xu WeiDong
Department of Pediatrics, The People's Hospital of Suzhou New District, Suzhou, Jiangsu, China.
Department of Pediatrics, The Affiliated Zhangjiagang Hospital of Soochow University, Suzhou, Jiangsu, China.
Front Pediatr. 2025 Mar 7;13:1483522. doi: 10.3389/fped.2025.1483522. eCollection 2025.
The purpose of this study is to investigate the early diagnostic value of the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and C-reactive protein (CRP) in neonatal late-onset sepsis (LOS), as well as to evaluate the combined diagnostic utility of these markers for the early detection of neonatal LOS.
The late-onset sepsis of newborns admitted to the neonatal intensive care unit of our hospital were retrospectively collected. 142 children with Late-Onset Sepsis (LOS) were selected as the LOS group, 50 neonates with systemic infection were selected as the systemic infection group, 50 neonates who underwent physical examination were selected as the non-systemic infection group. The differences of NLR, PLR, platelet-to-neutrophil ratio (PNR), and C-reactive protein (CRP), Procalcitonin among the three groups were compared.
The levels of NLR and PLR in LOS group were significantly higher than those in systemic infection group and non-systemic infection group. The Receiver Operating Characteristic (ROC) curve result revealed that the area under ROC (AUC, Area Under Curve) of NLR for the diagnosis of LOS was 0.903. When the optimal cut-off value was 1.30, the sensitivity and specificity were 89.4% and 81.0%. The AUC of PLR for the diagnosis of LOS was 0.833. When the optimal truncation value was 57.86, the sensitivity and specificity were 92.3% and 68.0%. The AUC of CRP for the diagnosis of LOS was 0.876, and the sensitivity and specificity were 76.8% and 87.0% when the optimal cut-off value was 10.21 mg/dl. When NLR, PLR, and CRP were combined to diagnosis LOS, The AUC was 0.942, the sensitivity and specificity were 90.8% and 86.0%.
The levels of NLR and PLR in the LOS were higher, which have certain value in the early diagnosis of LOS, and combined with CRP can improve the diagnostic efficiency.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及C反应蛋白（CRP）在新生儿晚发型败血症（LOS）中的早期诊断价值，并评估这些标志物联合诊断在新生儿LOS早期检测中的效用。
回顾性收集我院新生儿重症监护病房收治的新生儿晚发型败血症病例。选取142例晚发型败血症患儿作为LOS组，50例全身性感染新生儿作为全身性感染组，50例接受体格检查的新生儿作为非全身性感染组。比较三组间NLR、PLR、血小板与中性粒细胞比值（PNR）、C反应蛋白（CRP）及降钙素原的差异。
LOS组的NLR和PLR水平显著高于全身性感染组和非全身性感染组。受试者工作特征（ROC）曲线结果显示，NLR诊断LOS的ROC曲线下面积（AUC，曲线下面积）为0.903。当最佳截断值为1.30时，敏感性和特异性分别为89.4%和81.0%。PLR诊断LOS的AUC为0.833。当最佳截断值为57.86时，敏感性和特异性分别为92.3%和68.0%。CRP诊断LOS的AUC为0.876，当最佳截断值为10.21mg/dl时，敏感性和特异性分别为76.8%和87.0%。当NLR、PLR和CRP联合诊断LOS时，AUC为0.942，敏感性和特异性分别为90.8%和86.0%。
LOS中NLR和PLR水平较高，在LOS早期诊断中有一定价值，联合CRP可提高诊断效率。
