目的 探讨全血C-反应蛋白(C-reactive protein,CRP)联合白细胞参数对支原体感染上呼吸道感染患儿伴发脓毒症的预测价值.方法 选取2018年5月至2022年1月皖西卫生职业学院附属医院收治的124例急性上呼吸道感染且支原体IgM抗体检测阳性患儿作为研究对象,依据是否伴发脓毒症分为两组,其中伴发脓毒症患儿作为观察组(n=35),未伴发脓毒症患儿作为对照组(n=89),检测并分析各组患儿白细胞(white blood cell,WBC)、单核细胞(monocyte,Mon)、淋巴细胞(lymphocyte,Lym)、中性粒细胞(neutrophil,Neu)、嗜酸性粒细胞(eosinophils,Eos)、嗜碱性粒细胞(basophil,Bas)、中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、单核细胞与淋巴细胞比值(monocyte to lymphocyte ratio,MLR)和CRP水平,二元Logistic回归分析伴发脓毒症的危险因素,受试者工作特征(receiver operating characteristics,ROC)曲线分析单一指标和联合指标的预测价值.结果 观察组的Lym、Eos和CRP明显高于对照组,MLR明显低于对照组(P＜0.05);两组在年龄、性别、WBC、Neu、Mon、Bas和NLR上差异无统计学意义(P＞0.05).二元Logistic 回归分析显示,Eos(OR=17.364,95％CI:1.113～270.845)、CRP(OR=1.128,95％CI:1.055～1.206)和MLR(OR=0.005,95％CI:0.000～0.362)均是支原体感染的上呼吸道感染患儿伴发脓毒症的危险因素.ROC曲线分析显示Eos、CRP和MLR预测支原体感染的上呼吸道感染患儿伴发脓毒症的ROC曲线下面积(area under curve,AUC)分别为0.677、0.700和0.647;Eos+CRP+MLR联合预测的AUC=0.843,明显高于单独预测的AUC(P＜0.05),联合预测的灵敏度和特异度分别为77.10％和75.30％.结论 Eos、CRP和MLR均是支原体感染的上呼吸道感染患儿伴发脓毒症的危险因素,三者联合检测可以提高急性上呼吸道支原体感染进展为脓毒症的预测价值.
The Prediction of C-reactive Protein Combined with White Blood Cell Parameters for Sepsis in Children with Upper Respiratory Tract Infection Caused by Mycoplasma Pneumoniae
Objective To explore the predictive value of white blood cell parameters combined with C-reactive protein(CRP)for sepsis in children with upper respiratory tract infection caused by mycoplasma pneumoniae.Methods A total of 124 children with acute upper respiratory tract infection and positive mycoplasma pneumoniae IgM antibody were selected as the study objects from May 2018 to January 2022 in the Affiliated Hospital of West Anhui Health Vocational College.The patients with sepsis were divided into two groups according to whether they had sepsis or not.The patients with sepsis were treated as the observation group(n=35),and the patients without sepsis were treated as the control group(n=89).White blood cell(WBC),monocyte(Mon),lymphocyte(Lym),neutrophil(Neu),eosinophils(Eos),Basophil(Bas),neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR)and CRP levels were detected and analyzed in each group.The risk factors of sepsis were analyzed by binary logistic regression,and the predictive value of single and combined indicators was analyzed by receiver operating characteristics(ROC)curve.Results The Lym,Eos,and CRP of the observation group were significantly higher than those of the control group,while the MLR was significantly lower than that of the control group(P＞0.05);there was no significant difference in age,gender,WBC,Neu,Mon,Bas,and NLR between the two groups(P＜0.05).Binary logistic regression analysis showed that Eos(OR=17.364,95％CI:1.113-270.845),CRP(OR=1.128,95％CI:1.055-1.206),and MLR(OR=0.005,95％CI:0.000-0.362)were all risk factors for sepsis in children with upper respiratory tract infections caused by mycoplasma pneumoniae.ROC curve analysis showed that Eos,CRP and MLR predicted the area under curve of sepsis in children with upper respiratory tract infection with mycoplasma pneumoniae.AUC was 0.677,0.700 and 0.647,respectively.The AUC of Eos+CRP+MLR combined prediction was 0.843,which was significantly higher than that of single prediction(P＜0.05),and the sensitivity and specificity of combined prediction were 77.10％and 75.30％,respectively.Conclusion TEos,CRP,and MLR are all risk factors for sepsis in children with upper respiratory tract infections caused by mycoplasma pneumoniae.The combined detection of Eos,CRP,and MLR can improve the predictive value of acute upper respiratory tract infections progressing to sepsis.
upper respiratory tract infectionsepsismycoplasma pneumoniaeC-reactive proteineosinophilsmonocyte to lymphocyte ratio
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NSTL
万方数据
