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血细胞亚型比值和炎症指标在新型冠状病毒肺炎中的临床应用 被引量:1

Clinical application of blood cell subtype ratio and inflammatory indicators in COVID-19
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摘要 目的探讨血细胞亚型比值[中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、血小板/中性粒细胞比值(PNR)]和炎症指标在新型冠状病毒肺炎患者临床治疗和预后中的应用价值。方法回顾性收集2020年2-4月惠州市中心人民医院47例COVID-19住院患者(感染组)和30名健康体检者(对照组)的血常规和炎症指标数据,计算NLR、PLR和PNR比值,比较两组各项指标差异,动态监测NLR、PLR和PNR在病程中的变化趋势。绘制受试者工作特征曲线(ROC)评估血细胞亚型比值和炎症指标的诊断价值。结果与对照组相比,新冠患者的白细胞(WBC)和淋巴细胞计数(LYMPH)降低(Z=-3.578、-5.558,P均<0.05),NLR、PLR、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、SAA/CRP增高(Z=-4.210、-5.087、-2.434、-5.263、-3.091,P均<0.05),差异均有统计学意义。NLR、PLR和PNR变化趋势分析,发现NLR、PLR先升高达到峰值,随着患者病情好转呈现出逐步降低趋势(χ^(2)=27.441、38.699,P均<0.05)。ROC曲线分析结果显示,SAA、PLR、NLR、CRP曲线下面积(AUC)分别为0.855、0.845、0.786、0.662。结论NLR、PLR与SAA、CRP炎症指标联合应用能更好地反映患者全身性炎症状态,对疾病监测和预后判断有较好的临床诊断价值。 Objective To explore the application value of blood cell subtype ratio[neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),platelet/neutrophil ratio(PNR)]and inflammatory indicators in clinical treatment and prognosis of coronavirus disease 2019(COVID-19)patients.Methods The blood routine and inflammatory data were collected from 47 hospitalized COVID-19 patients and 30 healthy subjects and analyzed retrospectively,and the ratios of NLR,PLR and PNR were calculated.The differences of each index were compared between the two groups,and the variation trend of NLR,PLR and PNR were dynamically monitored during the course of disease.ROC curve was used to evaluate the diagnostic value of blood cell subtype ratio and inflammatory indicators.Results Compared with the control group,white blood cell(WBC)and lymphocyte(LYMPH)were decreased(Z=-3.578,-5.558,all P<0.05),and NLR,PLR,C-reactive protein(CRP),serum amyloid A(SAA)and SAA/CRP were increased in COVID-19 patients group(Z=-4.210,-5.087,-2.434,-5.263,-3.091,all P<0.05).Trend analysis of NLR,PLR and PNR showed that NLR and PLR increased first and reached the peak,and gradually decreased with the improvement of patients’condition(χ^(2)=27.441,38.699,all P<0.05).ROC curve analysis results showed that the area under curve(AUC)of SAA,PLR,NLR and CRP were 0.855,0.845,0.786 and 0.662,respectively.Conclusions The combination of NLR,PLR,SAA and CRP could reflect systemic inflammatory status of patients,and had good clinical diagnostic value for disease monitoring and prognosis.
作者 曹碧红 庄云菁 吴显劲 王春晖 CAO Bi⁃hong;ZHUANG Yun⁃jing;WU Xian⁃jin;WANG Chun⁃hui(Inspection Center of Huizhou Municipal Central Hospital,Huizhou,Guangdong 516001,China)
出处 《热带医学杂志》 CAS 2022年第8期1122-1125,共4页 Journal of Tropical Medicine
基金 惠州市科技计划项目(210422164575468)
关键词 新型冠状病毒肺炎 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 血小板/中性粒细胞比值 血清淀粉样蛋白A COVID-19 Neutrophil/lymphocyte ratio Platelet/lymphocyte ratio Platelet/neutrophil ratio Serum amyloid A
作者简介 曹碧红(1970-),女,本科,副主任技师,主要从事临床检验相关工作;通信作者:王春晖,E⁃mail:gzsmuwon2010@163.com
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