[1]王珍凤,田晓怡.儿童甲、乙型流感病毒感染外周血中性粒细胞 /淋巴细胞比值的临床意义[J].现代检验医学杂志,2019,34(06):60-62.[doi:10.3969 ／ j.issn.1671-7414.2019.06.014]
　WANG Zhen-feng,TIAN Xiao-yi.Clinical Significance of Peripheral Blood Neutrophil-to-Lymphocyte Ratio in Influenza A and B Virus Infections in Children[J].Journal of Modern Laboratory Medicine,2019,34(06):60-62.[doi:10.3969 ／ j.issn.1671-7414.2019.06.014]
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儿童甲、乙型流感病毒感染外周血中性粒细胞 /淋巴细胞比值的临床意义 ()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年06期
页码:
60-62
栏目:
论著
出版日期:
2019-12-30

文章信息/Info

Title:
Clinical Significance of Peripheral Blood Neutrophil-to-Lymphocyte Ratio in Influenza A and B Virus Infections in Children
文章编号:
1671-7414（2019）06-060 -04
作者:
王珍凤; 田晓怡
( 国家儿童医学中心，首都医科大学附属北京儿童医院检验中心，北京 100045)
Author(s):
WANG Zhen-feng;  TIAN Xiao-yi
（Department of Clinical Laboratory, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045,China）
关键词:
儿童; 甲、乙型流感病毒感染; 中性粒细胞/ 淋巴细胞比值
分类号:
R373.13；R446.111
DOI:
10.3969 ／ j.issn.1671-7414.2019.06.014
文献标志码:
A
摘要:
目的　探讨外周血全血细胞分析中的四项指标在儿童甲、乙型流感病毒感染中的临床意义。方法　回顾性分 析2018 年1 月~2019 年1 月在北京儿童医院就诊的发热和/ 或急性呼吸道症状的门诊患儿468 例。采用间接免疫荧光 法检测血清甲、乙型流感病毒IgM 抗体，采用流式细胞计数法进行外周血全血细胞分析。每组按年龄分为＜ 4 岁组和 ≥ 4 岁组。研究组纳入甲型流感患儿138 例，乙型流感患儿177 例，对照组纳入有呼吸道感染症状但甲、乙型流感病毒 阴性的患儿153 例。分别比较三组白细胞(white blood cell，WBC)、中性粒细胞(neutrophil，NEU)、淋巴细胞(lymphocyte， LYM)和中性粒细胞/ 淋巴细胞比值 (neutrophil-to-lymphocyte ratio，NLR)的水平，并对结果进行统计学分析。结果　在＜ 4 岁组和≥ 4 岁组中，四项指标与对照组相比差异有统计学意义( ＜ 4 岁组χ2=48.721~159.45，≥ 4 岁组χ2=36.79~93.56， 均P ＜ 0.001)。＜ 4 岁组，四项指标的受试者特征曲线(receiver operator characteristic curve，ROC) 的曲线下面积(area under the curve，AUC) 分别为0.765，0.904，0.742 和0.924，当NLR 取临界值1.12 时，敏感度为87.8%，特异度为 86.3%。≥ 4 岁组，四项指标的ROC-AUC 分别为0.823，0.937，0.799 和0.977，当NLR 取临界值1.65 时，敏感度为 94.1%，特异度为94.8%。进一步对甲、乙流感组进行比较，＜ 4 岁组中，两组之间WBC，NEU 和NLR 差异有统计学 意义(P ＜ 0.001)。结论　NLR 优于其他三项常规感染指标，有望作为诊断儿童甲、乙流感病毒感染的潜在指标。
Abstract:
Objective　To explore the clinical significance of four markers in peripheral complete blood cell count in children with influenza A and B virus infections. Methods　468 pediatric outpatients with fever and/or acute respiratory illness from January 2018 to January 2019 in Beijing Children’s Hospital were studied retrospectively. Influenza A and B virus IgM antibodies were detected by indirect immunofluorescent assay, and peripheral complete blood cell count was analyzed by flow cytometry. Each group was divided into less than four years old and greater than or equal to four years old. Included 138 influenza A patients, 177 influenza B patients as research group and 153 patients with respiratory symptoms but influenza virus A and B test-negative as control group. Compared the white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM) and neutrophil-to-lymphocyte ratio (NLR) among these three groups. Results　The levels of four markers in influenza groups were different than those in control group in both age groups, and the difference were statistically significant (in ＜ 4 years old group χ2=48.721~159.45 and in ≥ 4 years old group χ2=36.79~93.56, all P ＜ 0.001). In ＜ 4 years old age group, the area under the receiver operating characteristic curve (ROC-AUC) for diagnosing influenza infection of four markers were 0.765,0.904,0.742 and 0.924, respectively, when the cutoff value for NLR was 1.12, the sensitivity was 87.8% and the specificity was 86.3%. In ≥ 4 years old age group, the ROC-AUC of four markers were 0.823,0.937,0.799 and 0.977 respectively, when the cutoff value for NLR was 1.65, the sensitivity was 94.1% and the specificity was 94.8%. Furtherly, in ＜ 4 years old age group, WBC, NEU and NLR were significantly different between ininfluenza A and B groups (P ＜ 0.001). Conclusion　NLR was the better marker than the other three ones, and it may have the potential to serve as an auxiliary diagnostic marker for pediatric influenza A and B virus infections.

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备注/Memo

备注/Memo:
基金项目：北京市医院管理局“青苗”计划专项（QML 20171205） ；首都医科大学附属北京儿童医院苗圃计划（BCHYIPB-2016-01）。 作者简介：王珍凤(1984-)，女，本科，检验技师，主要研究方向：临床检验诊断学，E-mail: zx_cn999@163.com。 通讯作者：田晓怡(1985-)，女，博士，主管技师，主要研究方向：儿童疾病分子诊断，E-mail:xiaoyitianpumc@163.com 收稿日期：2019-07-30
更新日期/Last Update: 2019-12-25