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发育医学电子杂志  2024, Vol. 12 Issue (4): 278-283    DOI: 10.3969/j.issn.2095-5340.2024.04.006
  生长发育   论著 |
NLR、LDH、IL-6 在肺炎支原体肺炎患儿病情及预后评估中的价值
吴玉芹 黄荣卫 刘兴祝 杨燕飞 王智海
(昆明市儿童医院 特需病区,云南昆明 630228)
Value of NLR, LDH and IL-6 in the assessment of disease condition and prognosis of childrenwith Mycoplasma pneumoniae pneumonia
Wu Yuqin, Huang Rongwei, Liu Xingzhu, et al
(Department of Special Ward,Kunming Children's Hospital, Yunnan, Kunming 630228, China)
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摘要 【摘要】 目的  探讨肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)患儿中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、乳酸脱氢酶(lactate dehydrogenase,LDH)、白细胞介素-6(lnterleukin-6,IL-6)水平在预后评估中的价值。 方法 采用前瞻性研究方法,选取2020 年9 月至2021 年2 月昆明市儿童医院收治的180 例MPP 患儿作为观察组,其中普通患儿104 例,重症患儿76 例;另选取同期健康体检儿童60 例作为对照组。比较观察组和对照组NLR、LDH、IL-6 水平,评价NLR、LDH、
IL-6 对MPP 患儿病情严重程度的评估价值。根据MPP 预后情况,将患儿分为预后不良组(n=35)和预
后良好组(n=145)。比较不同预后MMP 患儿的临床资料、NLR、LDH、IL-6 水平,分析MPP 患儿预后影
响因素及NLR、LDH、IL-6 与临床肺部感染评分(Clinical Pulmonary Infection Score,CPIS)、白细胞计数
(white blood cell count,WBC)、降钙素原(procalcitonim,PCT)及C 反应蛋白(C-reactive protein,CRP)的相关性。统计学方法采用t 检验、χ2 检验、Logistic 回归分析、受试者操作特征(receiver operating characteristic,ROC)曲线分析、Spearman 模型分析。 结果  观察组普通、重症患儿及对照组儿童NLR 分别为1.5±0.3、2.2±0.3、1.2±0.2,LDH 水平分别为(439.8±30.1) U/L、(528.6±35.6) U/L、(125.8±28.9) U/L,IL-6 水平分别为(18.3±1.3) ng/L、(25.8±2.1) ng/L、(9.5±1.2) ng/L ;观察组普通、重症患儿NLR、LDH、IL-6 水平高于对照组(NLR:t=10.135、27.514,LDH:t=86.323、103.974,IL-6:t=44.834、84.297,P 值均<0.05),且观察组普通患儿NLR、LDH、IL-6 水平低于重症患儿(NLR:t=20.599,LDH:t=26.252,IL-6:t=48.065,P 值均<0.05)。NLR、LDH、IL-6 联合评估的曲线下面积(area under the curve,AUC)最大,为0.911,灵敏度、特异度分别为82.89%、89.42% ;CPIS 评分(OR=7.232,95% CI :5.055~10.347)、WBC(OR=6.839,95% CI :4.752~9.844)、PCT(OR=8.882,95% CI :6.375~12.374)、CRP(OR=11.520,95% CI :8.125~16.333)、NLR(OR=11.517,95%CI :7.852~16.894)、LDH(OR=11.881,95% CI :7.698~18.337)、IL-6(OR=12.424,95% CI :8.025~19.235) 均为MPP 患儿预后的独立危险因素(P 值均<0.05);MPP 患儿NLR、LDH、IL-6 水平与CPIS 评分、WBC、PCT、CRP 均呈正相关(P 值均<0.05)。 结论 MPP 患儿NLR、LDH、IL-6 水平明显升高,可作为MPP病情及预后评估的潜在指标。
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关键词:  肺炎支原体肺炎  中性粒细胞与淋巴细胞比值  乳酸脱氢酶  白细胞介素-6  病情严重程度  预后    
Abstract: 【Abstract】 Objective To explore the value of neutrophil-to-lymphocyte ratio (NLR), lactate
dehydrogenase (LDH), and interleukin-6 (IL-6) levels in prognostic assessment of children with Mycoplasmapneumoniae pneumonia (MPP). Method A total of 180 children with MPP admitted to KunmingChildren's Hospital from September 2020 to February 2021 were selected as the observation group byprospective studies, including 104 ordinary children and 76 severe children, and 60 healthy children whounderwent physical examination during the same period were selected as the control group. The levels ofNLR, LDH, and IL-6 were compared between the observation group and the control group to evaluate theevaluation value of NLR, LDH, and IL-6 for the severity of MPP in children. According to the prognosisof MPP, the children with MMP were divided into poor prognosis group (n=35) and good prognosis group(n=145). The clinical data, NLR, LDH, and IL-6 levels of MMP children with different prognoses werecompared, and the prognostic factors of MPP in children and the correlation between NLR, LDH, IL-6 andClinical Pulmonary Infection Score (CPIS), white blood cell count (WBC), procalcitonim (PCT), C-reactiveprotein (CRP) were analyzed. Statistical methods performed by t-test, χ2 test, Logistic regression analysis, receiveroperating characteristic (ROC) curve analysis and Spearman model analysis.  Result The NLR of ordinary andsevere children in the observation group and the control group were 1.5±0.3, 2.2±0.3 and 1.2±0.2, respectively,and the levels of LDH were (439.8±30.1) U/L, (528.6±35.6) U/L and (125.8±28.9) U/L, respectively, the levelsof IL-6 were (18.3±1.3) ng/L, (25.8±2.1) ng/L and (9.5±1.2) ng/L, respectively, and the NLR, LDH, andIL-6 levels in the observation group were higher than those in the control group (NLR: t=10.135, 27.514,LDH: t=86.323, 103.974, IL-6: t=44.834, 84.297, all P<0.05), and the NLR, LDH, and IL-6 levels in theordinary children of observation group were lower than those in the severe children (NLR: t=20.599, LDH:t=26.252, IL-6: t=48.065, all P<0.05). The area under the curve (AUC) of the combined assessment ofNLR, LDH, and IL-6 was the highest, at 0.911, with the sensitivity and specificity of 82.89% and 89.42%,respectively. The CPIS (OR=7.232, 95% CI: 5.055-10.347), WBC (OR=6.839, 95% CI: 4.752-9.844), PCT(OR=8.882, 95% CI: 6.375-12.374), CRP (OR=11.520, 95% CI: 8.125-16.333), NLR (OR=11.517, 95% CI:7.852-16.894), LDH (OR=11.881, 95% CI: 7.698-18.337), and IL-6 (OR=12.424, 95% CI: 8.025-19.235)were the independent risk factors for the prognosis of MPP childrenin (all P<0.05). The levels of NLR, LDHand IL-6 in children with MPP were positively correlated with CPIS, WBC, PCT and CRP (all P<0.05). Conclusion The levels of NLR, LDH and IL-6 in children with MPP are significantly increased, which canbe used as potential indicators for evaluating the condition and prognosis of MPP.
Key words:  Mycoplasma pneumoniae pneumonia    Neutrophil-to-lymphocyte ratio    Lactate dehydrogenase    Lnterleukin-6    Severity of disease    Prognosis
收稿日期:  2023-05-12                     发布日期:  2024-07-31     
基金资助: 昆明市卫生健康委员会卫生科研课题(2020-06-01-111)
通讯作者:  黄荣卫    E-mail:  13769156710@163.com
引用本文:    
吴玉芹 黄荣卫 刘兴祝 杨燕飞 王智海. NLR、LDH、IL-6 在肺炎支原体肺炎患儿病情及预后评估中的价值[J]. 发育医学电子杂志, 2024, 12(4): 278-283.
Wu Yuqin, Huang Rongwei, Liu Xingzhu, et al. Value of NLR, LDH and IL-6 in the assessment of disease condition and prognosis of childrenwith Mycoplasma pneumoniae pneumonia. Journal of Developmental Medicine(Electronic Version), 2024, 12(4): 278-283.
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