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
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