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目的研究中性粒细胞/淋巴细胞比值(NLR)对新生儿缺氧缺血性脑病(HIE)早期分度诊断的价值。方法收集兰州大学第二医院新生儿科HIE病例134例,其中轻度HIE组42例,中重度HIE组36例,正常对照组56例。内容包括患儿一般资料,出生分娩情况,第1、3、7天血常规,计算NLR和血小板/淋巴细胞比值(PLR),生后1周内行头颅MRI检查,采用单因素分析、受试者工作特征曲线(ROC)及Kappa一致性检验判断进行统计学分析。结果单因素分析显示,第1天和第3天白细胞、中性粒细胞、NLR是中重度HIE组的危险因素,第1天中重度HIE组NLR较同期正常对照组明显升高(5.55±1.88vs 2.63±0.91,P<0.05),轻度HIE组NLR升高不明显(2.71±0.92vs 2.63±0.91,P>0.05),中重度HIE组NLR明显高于轻度HIE组(5.55±1.88vs 2.71±0.92,P<0.05);ROC曲线显示第1天NLR效能最高(曲线下面积达0.959),灵敏度高达93.3%,特异度达81.0%,最佳截断点为3.43;Kappa检验显示NLR与1周内头颅MRI结果基本一致。结论新生儿窒息1周内NLR对HIE早期分度诊断具有一定预测价值。
Objective To investigate the value of neutrophil / lymphocyte ratio (NLR) in the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE). Methods Totally 134 neonates with HIE were collected from the Second Hospital of Lanzhou University. There were 42 mild HIE patients, 36 moderate HIE patients and 56 normal controls. The data included the general data of children, birth and delivery, blood routine on day 1, 3, and 7, NLR and platelet / lymphocyte ratio (PLR) were calculated, and cranial MRI was performed within 1 week after birth. Univariate analysis Working characteristic curve (ROC) and Kappa consistency test to determine the statistical analysis. Results Univariate analysis showed that leukocyte, neutrophil and NLR were the risk factors of moderate and severe HIE on day 1 and day 3. The NLR of moderate to severe HIE group was significantly higher than that of the normal control group on the first day (5.55 ± 1.88 (2.71 ± 0.92vs 2.63 ± 0.91, P> 0.05). The NLR of moderate and severe HIE group was significantly higher than that of mild HIE group (5.55 ± 1.88vs vs 2.63 ± 0.91, P <0.05) 2.71 ± 0.92, P <0.05). The ROC curve showed the highest efficacy of NLR on the first day (the area under the curve was 0.959), the sensitivity was as high as 93.3%, the specificity was 81.0%, the best cutoff point was 3.43; Kappa test showed that NLR and 1 Week of cranial MRI results are basically the same. Conclusion NLR within one week of neonatal asphyxia has certain predictive value for the early diagnosis of HIE.