Shen Jie, Zhong Qing, Su Jing, Shen Xuan, Li Wenya, Sun Tianyu, Zhang Yaoyun, Qi Jijin
Department of Clinical Laboratory, Jiangsu Province (Suqian) Hospital, Suqian, Jiangsu, China.
Department of Hematology Laboratory, Jiangsu Province (Suqian) Hospital, Suqian, Jiangsu, China.
Front Pediatr. 2025 Jul 18;13:1599694. doi: 10.3389/fped.2025.1599694. eCollection 2025.
The objective of this study was to evaluate the diagnostic significance of various immune cell ratios in children with sepsis via the analysis of clinical data.
This retrospective study analyzed clinical data admitted to the pediatric intensive care unit (PICU) of Jiangsu Province (Suqian) Hospital between January 2023 and December 2024. Receiver operating characteristic (ROC) curve analysis evaluated the diagnostic performance of peripheral blood laboratory assessments and Immune cell ratios (platelet count divided by lymphocyte count (PLR), monocyte count divided by lymphocyte count (MLR), neutrophil count divided by lymphocyte count (NLR), the ratio of neutrophils to (white blood cells-neutrophils) (dNLR), and neutrophil count multiplied by 100 divided by (lymphocyte count multiplied by platelet count) (NLPR)). Using Statistical Package for the Social Sciences (SPSS) 26.0 performed by Mann-Whitney U and Chi-square tests, with significance defined as < 0.05.
We analyzed the clinical data from 321 pediatric patients [201 sepsis (SP) and 120 healthy controls (HC)]. Compared to HC, the SP group exhibited elevated white blood cell (WBC), neutrophils, procalcitonin (PCT), platelets (PLT), and erythrocyte sedimentation rate (ESR) but reduced lymphocytes, monocytes, and hemoglobin; C-reactive protein (CRP) was significantly increased in the SP group ( < 0.001). ROC analysis identified NLR [The area under the ROC curve (AUC) = 0.932], PLR (AUC = 0.907), and NLPR (AUC = 0.848) as effective immune ratio biomarkers, while MLR (AUC = 0.784) showed limited utility. Among laboratory tests, WBC (AUC = 0.902), neutrophils (AUC = 0.919), CRP (AUC = 0.923), PLT (AUC = 0.879), and ESR (AUC = 0.875) demonstrated strong diagnostic accuracy, whereas lymphocyte, monocyte, and hemoglobin levels were less discriminative.
Our study reveals that combining immune cell ratios and CRP significantly enhances early detection of pediatric sepsis, improving clinical outcomes.
本研究的目的是通过分析临床数据来评估各种免疫细胞比率在儿童脓毒症中的诊断意义。
这项回顾性研究分析了2023年1月至2024年12月期间江苏省（宿迁）医院儿科重症监护病房（PICU）收治的临床数据。采用受试者工作特征（ROC）曲线分析来评估外周血实验室检查和免疫细胞比率（血小板计数除以淋巴细胞计数（PLR）、单核细胞计数除以淋巴细胞计数（MLR）、中性粒细胞计数除以淋巴细胞计数（NLR）、中性粒细胞与（白细胞-中性粒细胞）的比率（dNLR）以及中性粒细胞计数乘以100除以（淋巴细胞计数乘以血小板计数）（NLPR））的诊断性能。使用社会科学统计软件包（SPSS）26.0进行Mann-Whitney U检验和卡方检验，显著性定义为<0.05。
我们分析了321例儿科患者的临床数据[201例脓毒症（SP）患者和120例健康对照（HC）]。与HC相比，SP组白细胞（WBC）、中性粒细胞、降钙素原（PCT）、血小板（PLT）和红细胞沉降率（ESR）升高，但淋巴细胞、单核细胞和血红蛋白降低；SP组C反应蛋白（CRP）显著升高（<0.001）。ROC分析确定NLR[ROC曲线下面积（AUC）=0.932]、PLR（AUC=0.907）和NLPR（AUC=0.848）为有效的免疫比率生物标志物，而MLR（AUC=0.784）效用有限。在实验室检查中，WBC（AUC=0.902）、中性粒细胞（AUC=0.919）、CRP（AUC=0.923）、PLT（AUC=0.879）和ESR（AUC=0.875）显示出较强的诊断准确性，而淋巴细胞、单核细胞和血红蛋白水平的鉴别能力较差。
我们的研究表明，将免疫细胞比率与CRP相结合可显著提高儿童脓毒症的早期检测率，改善临床结局。
