The Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio for Detecting Early-onset Neonatal Sepsis
The Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio for Detecting Early-onset Neonatal Sepsis
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DOI：
10.1097/mph.0000000000001059
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发表时间：
2018-05-01
影响因子：
1.2
通讯作者：
Can, Ceren
中科院分区：
文献类型：
--
作者：
Can, Emrah;Hamilcikan, Sahin;Can, Ceren
目的：探讨足月新生儿早发性脓毒症(EOS)与中性粒细胞/淋巴细胞比率(NLR)、血小板/淋巴细胞比率(PLR)的关系。材料与方法：对确诊为EOS的足月儿进行前瞻性观察，并与44例正常新生儿对照。排除标准为早产儿、胎龄按孕周大小、先兆子痫、妊娠期糖尿病、绒毛膜羊膜炎、先天畸形、紫蓝色先天性心脏病。结果：共纳入足月新生儿122例。其中78人被诊断为EOS，44人为健康对照组。心动过速和呼吸暂停伴心动过缓是EOS组新生儿最常见的临床体征。与对照组相比，这组患者的中性粒细胞计数、腋窝温度、NLR、PLR、C反应蛋白和降钙素原水平显著升高。在EOS组，中性粒细胞计数、NLR和PLR呈正相关。NLR6.76作为预测新生儿EOS的临界值(敏感度97.4%；特异度100%；受试者工作特征曲线下面积0.99；P=0.001)。预测新生儿EOS的临界值为PLR94.05(敏感度97.4；特异度100%；受试者工作特征曲线下面积0.93；P=0.001)。结论：NLR和PLR与足月新生儿EOS呈正相关，可作为新生儿EOS检查的辅助诊断指标。
Objective: The purpose of this study was to investigate the relationship between neonate early-onset sepsis (EOS) and the neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) of term neonates.Materials and Methods: This prospective observational study was conducted with term neonates diagnosed with EOS compared with 44 healthy controls. Exclusion criteria were prematurity, postmaturity, small or large for gestational age according to week of pregnancy, preeclampsia, gestational diabetes mellitus, chorioamnionitis, congenital major anomalies, and cyanotic congenital heart disease.Results: A total of 122 term neonates were included in the study. Of these, 78 were diagnosed with EOS and 44 were healthy controls. Tachycardia and apnea with bradycardia were the most common clinical signs of the onset of EOS in neonates in the EOS group. This group had significantly higher neutrophil counts, axillary temperatures, NLRs, PLRs, C-reactive proteins, and procalcitonin levels compared with the control group. There was a positive association between neutrophil counts, NLR, and PLR in the EOS group. An NLR of 6.76 was determined as the predictive cutoff value of neonate EOS (sensitivity 97.4%; specificity 100%; area under the receiver-operating characteristic curve 0.99; P = 0.001). A PLR of 94.05 was determined as the predictive cutoff value of neonate EOS (sensitivity 97.4; specificity 100%; area under the receiver-operating characteristic curve 0.93; P = 0.001).Conclusions: NLRs and PLRs were positively correlated with EOS in term neonates, and these ratios can be used as diagnostic adjunct tests for neonate EOS workups.