【摘要】 目的探讨中性粒细胞(NC)和中性粒细胞/淋巴细胞比值(NLR)在肾综合征出血热(HFRS)患者预测价值中的应用。方法选取2015年1月至2018年4月该院收治的119例HFRS患者(HFRS组),同时选取150例体检健康者作为健康对照组。比较NC、NLR在两组中的表达差异。收集HFRS患者的临床和实验室资料,统计分析各指标的差异,并采用受试者工作特征曲线(ROC曲线)分析NC和NLR对HFRS的诊断和预测价值。结果 HFRS患者NC、淋巴细胞(LC)、NLR、白细胞(WBC)、尿素氮(BUN)和肌酐(CREA)水平明显高于健康对照人群,差异具有统计学意义(P<0.05)。NLR预测HFRS的ROC曲线下面积(AUC)为0.711,95%CI为0.645～0.777,P=0.000。NC预测HFRS的AUC为0.812,95%CI为0.758～0.866,P=0.000。HFRS IgM阳性患者NLR水平显著高于IgM阴性患者,差异具有统计学意义(P<0.05)。NLR在HFRS IgG阴性和阳性患者及尿蛋白1+和尿蛋白3+患者间差异无统计学意义(P>0.05)。NC和NLR预测HFRS IgM阳性患者AUC为0.817和0.728。结论 NC和NLR可作为一种独立预测HFRS患者的生物标志物,其升高对预测HFRS IgM阳性患者具有重要的临床价值,能够为HFRS患者的预后管理提供理论依据。更多还原

【Abstract】 Objective To investigate the predictive value of neutrophil(NC)and neutrophil to lymphocyte ratio(NLR)in hemorrhagic fever with renal syndrome(HFRS).Methods The blood cell differential counting in 119 patients with HFRS(HFRS group),150 individuals undergoing the healty physical examination(health control group)were selected in a hospital from January 2015 to April 2018.Blood cells classification and count were performed.NC and NLR were compared among two groups.The clinical and laboratory data in the patients with HFRS were collected and other indicators were statistically analyzed.Moreover,the diagnostic and predictive value of NC and NLR were analyzed using the receiver operating characteristic curve(ROC).Results The NC,LC,NLR,WBC,BUN and CREA in the HFRS patients were significantly higher than the healthy controls,the difference was statistically significant(P<0.05).The AUC value of NLR for predicting HFRS was 0.711,95%CI 0.645-0.777,P=0.000.The AUC value of NC for predicting HFRS was 0.812,95%CI0.758-0.866,P=0.000.The NLR of HFRS IgM positive patients was significantly higher than that of IgM negative patients,and the difference was statistically significant(P<0.05).There was no statistically significant difference in NLR between IgG negative and positive patients with HFRS and urine protein 1+and urine protein 3+ patients(P>0.05).The AUC value of NC and NLR predicted the HFRS IgM positive patients was 0.817 and 0.728,respectively.Conclusion NC and NLR are expected to apply as a new biomarker for independently predicting the HFRS.The increasion of NC and NLR plays a significant role in predicting the IgM positive HFRS,and provide a guide of prognostic monitor for HFRS.更多还原