血尿素氮与中性粒细胞与淋巴细胞比值联合检测对新生儿重症肺炎合并脓毒症的预测价值

Predictive value of combined detection of blood Urea nitrogen and Neutrophil-to-lymphocyte ratio for identifying severe pneumonia complicated with sepsis in neonates.

作者信息

Gong Weihua, Gao Kaijie, Yang Liu, Li Teiwei, Sun Hongqi, Shan Zhiming, Li Ci, Yang Junmei, Ni Jiajia

机构信息

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

Guangzhou National Laboratory, Guangzhou, China.

出版信息

BMC Infect Dis. 2025 Aug 19;25(1):1045. doi: 10.1186/s12879-025-11471-8.

DOI:10.1186/s12879-025-11471-8

PMID:40830440

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12366305/

Abstract

BACKGROUND

Newborns with severe pneumonia are at a high risk of developing sepsis, and early identification of this risk can improve the prognosis for the affected children. The purpose of this study was to evaluate the predictive value of combining blood urea nitrogen (BUN) and neutrophil-to-lymphocyte ratio (NLR) in diagnosing neonatal severe pneumonia complicated with sepsis (NSPCS).

METHODS

We retrospectively included 194 newborns hospitalized from January 2018 to December 2021. Of these, 51 newborns with severe pneumonia developed sepsis. Clinical and laboratory data were collected from electronic medical records. The newborns were divided into severe pneumonia and sepsis groups. Multivariate logistic regression analysis was performed to determine whether BUN and NLR were independent predictors of NSPCS. The predictive value of combining BUN and NLR was assessed using receiver operating characteristic (ROC) curve analysis.

RESULTS

Newborns with severe pneumonia complicated by sepsis had elevated levels of BUN ( < 0.001) and NLR ( = 0.003). Correlation analysis indicated a positive correlation between NSPCS and levels of BUN ( = 0.341, < 0.001) and NLR ( = 0.213, = 0.003). Multiple logistic regression analysis revealed that BUN and NLR were independent risk factors for NSPCS. ROC curve analysis revealed that combining BUN and NLR had better efficacy in identifying NSPCS (AUC = 0.757, 95% CI: 0.681–0.834, < 0.001), with significantly better discriminatory ability than either BUN (AUC = 0.724, 95% CI: 0.643–0.804, < 0.001) or NLR (AUC = 0.640, 95% CI: 0.545–0.735, = 0.003) alone.

CONCLUSION

The combined detection of BUN and NLR was a valuable biomarker for identifying NSPCS.

WHAT IS KNOWN

: , ,

WHAT IS NEW

: This study determined the risk factors for NSPCS. ,

摘要

背景

患有严重肺炎的新生儿发生败血症的风险很高，早期识别这种风险可以改善患病儿童的预后。本研究的目的是评估联合检测血尿素氮（BUN）和中性粒细胞与淋巴细胞比值（NLR）在诊断新生儿重症肺炎合并败血症（NSPCS）中的预测价值。

方法

我们回顾性纳入了2018年1月至2021年12月期间住院的194例新生儿。其中，51例患有严重肺炎的新生儿发生了败血症。从电子病历中收集临床和实验室数据。将新生儿分为重症肺炎组和败血症组。进行多因素logistic回归分析以确定BUN和NLR是否为NSPCS的独立预测因素。使用受试者工作特征（ROC）曲线分析评估联合检测BUN和NLR的预测价值。

结果

患有严重肺炎并合并败血症的新生儿BUN水平升高（<0.001），NLR水平也升高（=0.003）。相关性分析表明，NSPCS与BUN水平（=0.341，<0.001）和NLR水平（=0.213，=0.003）呈正相关。多因素logistic回归分析显示，BUN和NLR是NSPCS的独立危险因素。ROC曲线分析显示，联合检测BUN和NLR在识别NSPCS方面具有更好的效能（AUC=0.757，95%CI：0.681-0.834，<0.001），其鉴别能力明显优于单独检测BUN（AUC=0.724，95%CI：0.643-0.804，<0.001）或NLR（AUC=0.640，95%CI：0.545-0.735，=0.003）。