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Open Access Article

International Journal of Clinical Research. 2023; 7: (12) ; 55-59 ; DOI: 10.12208/j.ijcr.20230369.

Relationship between NLR, CRP, PCT and severity of community-acquired pneumonia in children
NLR、CRP、PCT与儿童社区获得性肺炎病情严重程度相关性研究

作者: 李涛, 姚丽萍 *

包头医学院第一附属医院 内蒙古包头

*通讯作者: 姚丽萍,单位:包头医学院第一附属医院 内蒙古包头;

发布时间: 2023-12-29 总浏览量: 652

摘要

目的 探讨中性粒细胞/淋巴细胞比值(NLR)、血清降钙素原(PCT)、C反应蛋白(CRP)在预测儿童社区获得性肺炎(CAP)严重程度中的临床价值。方法 回顾分析我院2019年6月至2023年6月收治的符合儿童社区获得性肺炎的患儿189例患儿作为研究对象,依据儿童社区获得性肺炎诊疗规范(2019 版)中住院患儿推荐使用病情严重度评估表,将患儿分为重症肺炎组70例与轻症肺炎组119例,分别收集两组患儿临床资料,实验室检测血细胞参数及血清CRP、PCT水平,通过计算NLR,进行结果分析。结果 重症组血细胞参数白细胞计数、中性粒细胞、单核细胞、血小板计数均明显高于轻症组,而淋巴细胞明显低于轻症组,差异有统计学意义(P<0.05);重症组患儿NLR、CRP、PCT水平高于轻症组,差异有统计学意义(P<0.05);通过与疾病严重程度相关性分析显示NLR、CRP、PCT与疾病的严重程度相关系数分别为0.456、0.409、0.274,差异有统计学意义(P<0.05);多因素Logistic回归分析显示NLR、CRP、PCT均是影响疾病严重程度的独立危险因素(P<0.05)。结论 NLR、CRP、PCT与儿童社区获得性肺炎严重程度相关,对疾病早期严重程度有预测价值。

关键词: 儿童社区获得性肺炎;中性粒细胞/淋巴细胞比值(NLR);降钙素原;C反应蛋白

Abstract

Objective To investigate the clinical value of neutrophil/lymphocyte ratio (NLR), serum procalcitonin (PCT) and C-reactive protein (CRP) in predicting the severity of community-acquired pneumonia (CAP) in children.
Methods A total of 189 children with community-acquired pneumonia admitted to our hospital from June 2019 to June 2023 were retrospectively analyzed as the study objects. According to the recommended severity assessment table in the diagnosis and treatment guidelines for community-acquired pneumonia in children (2019 edition), the children were divided into a severe pneumonia group (70 cases) and a mild pneumonia group (119 cases). The clinical data of the two groups of children were collected, and the blood cell parameters and serum CRP and PCT levels were detected in the laboratory. The results were analyzed by calculating NLR.
Results The blood cell parameters WBC count, neutrophil, monocyte and platelet count in severe group were significantly higher than those in mild group, while lymphocytes were significantly lower than those in mild group, the difference was statistically significant (P < 0.05). The levels of NLR, CRP and PCT in severe group were higher than those in mild group, and the difference was statistically significant (P < 0.05). The correlation analysis between NLR, CRP and PCT and disease severity showed that the correlation coefficients were 0.456, 0.409 and 0.274, respectively, and the difference was statistically significant (P < 0.05). Multivariate Logistic regression analysis showed that NLR, CRP and PCT were independent risk factors for disease severity (P < 0.05).
Conclusion   NLR, CRP and PCT are correlated with the severity of community-acquired pneumonia in children, and have predictive value for the early severity of the disease.

Key words: Children community acquired pneumonia; Neutrophil/lymphocyte ratio (NLR); Procalcitonin; C-reactive protein

参考文献 References

[1] Esposito S, Daleno C, Prunotto G, et al. Impact of viral infections in children with community-acquired pneumonia: results of a study of 17 respiratory viruses[J]. Influenza Other Respir Viruses. 2013;7(1):18–26.

[2] Walker CLF, Rudan I, Liu L, et al. Global burden of childhood pneumonia and diarrhoea[J]. Lancet. 2013 Apr 20;381(9875):1405-1416. 

[3] 中华人民共和国国家健康委员会,国家中医药局. 儿童社区获得性肺炎诊疗规范(2019年版)[J]. 中华临床感染病杂志,2019,12(1):6-13.

[4] Klig JE. Office pediatrics: current perspectives on the outpatient evaluation and management of lower respiratory infections in children[J]. Curr Opin Pediatr [Internet]. 2006;18(1):71–6 

[5] Self WH, Grijalva CG, Williams DJ, et al. Procalcitonin as an early marker of the need for invasive respiratory or vasopressor support in adults with community-acquired pneumonia[J]. Chest. 2016;150(4):819–828  

[6] Stockmann C, Ampofo K, Killpack J, et al. Procalcitonin accurately identifies hospitalized children with low risk of bacterial community-acquired pneumonia[J]. Pediatric Infect Dis Soc. 2018;7(1):46–53 

[7] Wallihan RG, Suárez NM, Cohen DM, et al. Molecular distance to health transcriptional score and disease severity in children hospitalized with community-acquired pneumonia[J]. Front Cell Infect Microbiol. 2018;8:382

[8] N.D. Pantzaris, C. Platanaki, C. Pierrako, et al. Neutrophil-to-lymphocyte ratio relation to sepsis severity scores and inflammatory biomarkers in patients with community-acquired pneumonia: a case series[J]. Transl. Int. Med. 6 (1) (2018) 43–46. 

[9] Y.K. Huang, W.M. Deng, S.L. Zheng, et al., Relationship between monocytes to lymphocytes ratio and axial spondyloarthritis[J]. Immunopharmacol. 57 (2018) 43–46.

[10] Zhang HF, Ge YL, Wang HY, et al. Neutrophil-to -lymphocyte ratio improves the accuracy and sensitivity of pneumonia severity in-dex in predicting 30-day mortality of CAP patients [J]. Clin Lab,2019,65(10):190226.

[11] Che-Morales JL, Cortes-Telles A. Neutrophil-to-lymphocyte ratio as a serum biomarker associated with community acquired pneumonia[J]. Rev Med Inst Mex Seguro Soc,2019, 56(6):537-543.

[12] KA Rakioulaki M,Stolz D.Biomarkers in pneumonia-beyond procalcitonin[J]. Int J Mol Sci,2019,20(8)∶E2004. 

[13] Nascimento-CarvalhoCM, Cardoso MR, Barral A, et al. (2010) Procalcitonin isuseful inidentifyin gbacteraem iaamong childrenwith pneumonia[J]. Scand JInfect Dis 42: 644–649

[14] 惠晓霞,王琪,张文乾. 重症肺炎患儿血清 IL - 1R1、APC、 sICAM - 1、NLR 及 PLR 的变化及其临床意义[ J] . 实验与检验医学,2019,37(3) :465 - 467.

[15] 曾笑寒.NLR PCT和乳酸水平在社区获得性肺炎危险度分层中的预测价值[J].中国临床新医学,2021,14(09): 907-911.

[16] 许仙.肺炎支原体感染患儿血清NLR、D-二聚体和PCT的表达及临床价值分析[J].现代诊断与治疗,2022,33(17): 2629-2632.

[17] 董双霞,潘林艳,金海珍.重症肺炎中超敏C反应蛋白及D-二聚体早期诊疗价值及预后影响因素分析[J].中国药物与临床,2019,19(12):2035-2037.

[18] Knight SR, Ho A, Pius R, et al. Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO clinical characterisation protocol: development and validation of the 4C mortality score[J]. BMJ (2020) 370: m3339. 

[19] Liu F, Li L, Da X, et al. Prognostic value of interleukin6, c-reactive protein, and procalcitonin in patients with COVID-19[J]. J Clin Virol (2020) 127:104370.

[20] 王飞.PCT、CRP、WBC及NLR在老年人群细菌感染性疾病中的诊断价值[J].中国校医,2019,33(03):201-204.

[21] 陶慧娴.降钙素原、超敏C反应蛋白联合白介素6动态检测在新生儿感染早期诊断中的价值[J].中外医疗,2018, 37(01):34-36+42.

[22] 刘慧娟,蒋海平.hs-CRP、PCT、NLR联合检测在诊断细菌性血流感染中的临床价值[J].标记免疫分析与临床,2021, 28(06):951-954.

引用本文

李涛, 姚丽萍, NLR、CRP、PCT与儿童社区获得性肺炎病情严重程度相关性研究[J]. 国际临床研究杂志, 2023; 7: (12) : 55-59.