PCT,PLR and NLR in children with neonatal pneumonia and their predictive value for disease severity and prognosis
OBJECTIVE To explore serum procalcitonin(PCT),platelet-lymphocyte ratio(PLR)and neutrophil-lymphocyte ratio(NLR)in children with neonatal infectious pneumonia and their predictive value for disease se-verity and prognosis and analyze the values of the indexes in prediction of illness condition and prognosis.METHODS A total of 148 children with neonatal bacterial pneumonia in the Second Affiliated Hospital of Wenzhou Medical University between Jun.2021 and Sep.2023 were selected as the pneumonia group,of which 67 cases of severe pneumonia and 81 cases of mild pneumonia,and neonates with severe pneumonia were divided into the non-critical group(n=20),the critical group(n=31)and the extremely critical group(n=16)in accordance with the neonatal intensive illness score(NCIS).Another 140 healthy neonates with matched gender,gestational age,birth weight and day age during the same period were selected as the control group,the differences in peripheral blood PCT,PLR and NLR were compared among different groups,and the relationship between the peripheral blood in-dexes and the disease severity was analyzed.According to the survival of the children for 28 days,the children in the pneumonia group were divided into the survival group(n=129)and the death group(n=19),and the predic-tive value of the peripheral blood indexes on the prognosis of the children was analyzed.RESULTS A total of 154 strains of pathogenic bacteria were co-cultured and isolated from 148 pathogenically positive neonatal children,of which 122 strains of gram negative bacteria accounted for 79.22％.Totally 32 strains of gram positive bacteria ac-counted for 20.78％.The peripheral blood PCT,PLR,and NLR in the pneumonia group were(4.88±1.21)ng/ml,(184.29±38.36),and(7.33±1.30),respectively,which were higher than those in the control group(P＜0.05).The peripheral blood PCT,PLR,and NLR of children with severe pneumonia were(6.02±1.17)ng/ml,(199.19±24.53),and(9.12±1.27),respectively,which were higher than those of children with mild pneumonia(P＜0.05).PCT,PLR,and NLR were higher in critically ill children with severe pneumonia than in critically ill children,and higher in critically ill children than in non-critically ill children(P＜0.05).Spearman correlation showed that the levels of PCT,PLR,and NLR in peripheral blood were positively correlated with the severity of the disease in children(r=0.573,0.522,0.606,all P＜0.05).The peripheral blood PCT,PLR,and NLR of the death group were(7.06±1.23)ng/ml,(203.14±19.11),and(10.88±1.56),respectively,higher than those of the survival group(P＜0.05).The area under the ROC curve of the combined detection of peripheral blood PCT,PLR,and NLR for predicting the prognosis of children was 0.833,which was higher than that of the individual tests for each index(P＜0.05).CONCLUSION Peripheral blood levels of PCT,PLR and NLR are elevated in chil-dren with neonatal pneumonia,and their high expression correlates with the severity of the disease in children,which may predict the poor prognosis of the disease to a certain extent.
Neonatal infectious pneumoniaProcalcitoninPlatelet-lymphocyte ratioNeutrophil-lymphocyte ratioPrognosisPredictive value
万方数据
维普
