摘要
目的探讨支气管哮喘(以下简称哮喘)患儿急性发作期外周血常规指标和C-反应蛋白(C-reaction protein,CRP)的变化及其临床价值。方法选取2019年1月至2020年8月南京医科大学附属无锡儿童医院呼吸科确诊的哮喘患儿157例作为研究对象,并按其入院病情分为哮喘缓解期组67例和发作期组90例,并选择年龄、性别等相近的健康儿童59人作为对照组。采用医院电子病历系统收集研究对象的年龄、性别、血常规检查结果,并计算中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR),后比较三组年龄、性别等一般情况、血细胞计数、CRP、NLR和PLR等指标,采用多元logistic回归分析筛选哮喘发作的相关因素,并采用受试者工作特征(receiver operating characteristic,ROC)曲线评价其对哮喘发作的诊断价值。结果三组间白细胞计数(white blood cell,WBC)、淋巴细胞计数(lymphocyte,LY)、中性粒细胞计数(neutrophil,NE)、血小板计数(platelet,PLT)、血小板压积(platelet hematocrit,PCT)、血小板分布宽度(platelet distribution width,PDW)、CRP、NLR、PLR等指标比较,差异有统计学意义(P<0.05);而嗜酸性粒细胞计数(eosinophil,EO)、血红蛋白(hemoglobin,Hb)和红细胞分布宽度(red blood cell distribution width,RDW)比较,差异无统计学差异(P>0.05);哮喘发作期患儿与对照组受试者WBC、LY、NE、PLT、PCT、PDW、CRP、NLR、PLR比较,差异有统计学意义(P<0.05);哮喘发作期与缓解期LY、NE、PLT、PCT、PDW、CRP、NLR比较,差异有统计学意义(P<0.05)。Logistic回归分析发现,年龄、PCT与哮喘急性发作呈负相关,是保护因素;而CRP和NLR是哮喘急性发作的危险因素。ROC曲线发现CRP、NLR和PCT对哮喘急性发作具有诊断价值,其曲线下面积(AUC)分别为0.826、0.813和0.737。结论CRP及外周血常规指标NLR、PCT可作为儿童哮喘急性发作的预测评价指标。
Objective To explore the changes of C-reaction protein(CRP),neutrophil-to-lymphocyte ratio(NLR)and platelet hematocrit(PCT)in children with acute exacerbation of bronchial asthma.Methods Totally 157 patients with bronchial asthma,including 90 acute exacerbation children and 67 non-acute exacerbation children,were enrolled in this study according to the doctors’diagnosis,and 59 healthy subjects were selected as the control group.The hospital electronic medical record system was used to collect the age,gender,and blood routine examination results of the research subjects,and calculate the NLR and the platelet-to-lymphocyte ratio(PLR).Age,gender and other general conditions,blood cell count,CRP,NLR and PLR and other indicators were compared among the three groups.Multiple logistic regression analysis was used to screen the relevant factors of asthma attacks,and the receiver operating characteristic(ROC)curve was used to evaluates its diagnostic value for acute exacerbation of bronchial asthma.Results The results of white blood cell(WBC),lymphocyte(LY),neutrophil(NE),platelet(PLT),PCT,platelet distribution width(PDW),CRP,NLR and PLR were significant different among the three groups(P<0.05),but eosinophil(EO),hemoglobin(Hb),and red blood cell distribution width(RDW)had no significant difference(P>0.05).Compared with those in the healthy control group,levels of WBC,LY,NE,PLT,PCT,PDW,CRP,NLR and PLR of acute exacerbation group were significantly different(P<0.05).Compared with the remission group,levels of LY,NE,PLT,PCT,PDW,CRP and NLR of acute exacerbation group were significantly different(P<0.05).Logistic regression analysis showed that age and PCT were protective factors,but CRP and NLR were risk factors of acute exacerbation of bronchial asthma.The areas under the curve of CRP,NLR,PCT were 0.826,0.813 and 0.737,respectively,which were of diagnosis value for acute exacerbation of bronchial asthma.Conclusions CRP,NLR and PCT are independent factors of children with acute episodes of bronchial asthma,having greater clinical diagnosis value in acute exacerbation of bronchial asthma.
作者
张健
陈茜
周立娜
朱旭明
崔玉宝
ZHANG Jian;CHEN Xi;ZHOU Li-na;ZHU Xu-ming;CUI Yu-bao(Department of Clinical Laboratory,Wuxi Children’s Hospital Affiliated to Nanjing Medical University,Wuxi,Jiangsu 224003,China;不详)
出处
《慢性病学杂志》
2020年第12期1773-1777,1782,共6页
Chronic Pathematology Journal
基金
江苏省重点研发计划(BE2018627)
