【摘要】 目的 分析中性粒细胞与淋巴细胞比率(NLR)在诊断极低出生体质量儿晚发型败血症中的价值。方法 回顾性收集郑州大学第一附属医院收治的80例极低出生体质量儿血培养阳性的晚发型败血症患儿为晚发型败血症组，同时选取相同胎龄未发生感染的113例极低出生体质量儿作为对照组。实验室检查包括白细胞(WBC)计数、血小板(PLT)计数、C反应蛋白(CRP)、降钙素原(PCT)、NLR。利用受试者工作特征曲线分析PLT、CRP、PCT、NLR在极低出生体质量儿血培养阳性晚发型败血症中的诊断能力。结果 两组在胎龄、性别、出生体质量、感染日龄和WBC方面差异无统计学意义(P>0.05);晚发型败血症组PLT水平低于对照组，CRP、PCT、NLR水平高于对照组(P<0.05)。受试者工作特征(ROC)曲线分析显示，PLT、CRP、PCT及NLR诊断极低出生体质量儿晚发型败血症的特异度分别为75.0%、93.8%、95.6%、98.2%,敏感度分别为77.9%、78.8%、77.5%、81.3%,曲线下面积分别为0.834、0.851、0.908、0.954。结论 NLR是一种简单、廉价、快速的方法，可用于诊断血培养阳性的败血症并减少不必要的抗生素治疗。更多还原

【Abstract】 Objective To investigate the value of neutrophil to lymphocyte ratio(NLR) in the diagnosis of late-onset sepsis in very low birth weight infants. Methods A total of 80 very low birth weight infants with late-onset sepsis and positive blood culture in the First Affiliated Hospital of Zhengzhou University were retrospectively collected as the late-onset sepsis group, and 113 very low birth weight infants without infection at the same gestational age were selected as the control group. Initial laboratory investigations included white blood cell count(WBC), platelet count(PLT), C-reactive protein(CRP), procalcitonin(PCT) and NLR. The receiver operating characteristic(ROC) curve was used to analyze the diagnostic performance of PLT, CRP, PCT and NLR for neonatal blood culture-positive sepsis. Results There were no differences in gestational age, sex, birth weight, age of infection and WBC between the two groups(P>0.05). The late-onset sepsis group had a significantly lower PLT level and significantly higher CRP, PCT, and NLR levels than the control group(P<0.05). Receiver operating characteristic(ROC) curve analysis showed that the specificity of PLT, CRP, PCT and NLR in the diagnosis of late-onset sepsis in very low birth weight infants was 75.0%, 93.8%, 95.6% and 98.2%, respectively, and the sensitivity was 77.9%, 78.8%, 77.5% and 81.3%, respectively. The area under the curve was 0.834, 0.851, 0.908 and 0.954, respectively. Conclusion NLR is a simple, inexpensive and rapid method for diagnosing sepsis with positive blood cultures and reducing unnecessary antibiotic treatment.更多还原