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血小板与中性粒细胞比值在鉴别新生儿败血症与肺炎中的临床应用:一项观察性研究。

Clinical utility of the Platelet-to-neutrophil ratio in differentiating sepsis from neonatal pneumonia: an observational study.

作者信息

Li Ci, Feng Xiang, Yang Liu, Gao Kaijie, Zhu Zhiwei, Jiang Shicai, Ni Jiajia, Li Tiewei, Yang Junmei

机构信息

Department of Clinical Laboratory, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Key Laboratory of Children's Infection and Immunity, Zhengzhou, P.R. China.

Departement of Detection and Diagnosis Technology Research, Guangzhou National Laboratory, Guangzhou, Guangdong, P.R. China.

出版信息

Ann Med. 2025 Dec;57(1):2531252. doi: 10.1080/07853890.2025.2531252. Epub 2025 Jul 12.

Abstract

BACKGROUND

In some cases, neonates with pneumonia can develop sepsis. The timely and accurate diagnosis of sepsis due to neonatal pneumonia poses a challenge for many clinicians. Therefore, this study aimed to evaluate the potential of the platelet-to-neutrophil ratio (PNR), as an early biomarker for clinically differentiating neonatal sepsis among pneumonia cases.

METHODS

We performed a cross-sectional analysis of clinical and laboratory data collected from 1,103 patients with neonatal pneumonia [773 with pneumonia and 330 with pneumonia and sepsis (PS)].

RESULTS

The PS group had a lower PNR than the pneumonia group. Further analysis revealed that the incidence of PS was significantly higher in the low PNR group than in the high PNR group (43.9% vs. 15.9%,  < 0.01). Multivariate logistic regression analysis revealed that the PNR was an independent risk factor for sepsis in neonatal pneumonia. Receiver operating characteristic curve analysis demonstrated that the PNR has good efficacy in diagnosing neonatal patients with PS (area under curve = 0.76, 95% confidence interval: 0.73-0.80,  < 0.001).

CONCLUSIONS

PNR can serve as an early biomarker for differentiating neonatal sepsis among pneumonia cases. Despite its potential, the PNR requires validation in multicenter studies.

摘要

背景

在某些情况下,患有肺炎的新生儿会发展为败血症。对许多临床医生来说,及时、准确地诊断新生儿肺炎所致的败血症是一项挑战。因此,本研究旨在评估血小板与中性粒细胞比值(PNR)作为临床上区分肺炎病例中新生儿败血症的早期生物标志物的潜力。

方法

我们对从1103例新生儿肺炎患者[773例肺炎患者和330例肺炎合并败血症(PS)患者]收集的临床和实验室数据进行了横断面分析。

结果

PS组的PNR低于肺炎组。进一步分析显示,低PNR组的PS发病率显著高于高PNR组(43.9%对15.9%,<0.01)。多因素逻辑回归分析显示,PNR是新生儿肺炎败血症的独立危险因素。受试者工作特征曲线分析表明,PNR在诊断新生儿PS患者方面具有良好的效能(曲线下面积=0.76,95%置信区间:0.73-0.80,<0.001)。

结论

PNR可作为区分肺炎病例中新生儿败血症的早期生物标志物。尽管有其潜力,但PNR需要在多中心研究中进行验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ca/12258167/320b38cf6fb4/IANN_A_2531252_F0001_C.jpg

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