淋巴细胞与 C 反应蛋白比值作为疑似新生儿败血症的早期败血症生物标志物。
Lymphocyte-to-C-Reactive Protein Ratio as an Early Sepsis Biomarker for Neonates with Suspected Sepsis.
机构信息
Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China.
The Center of Henan Children's Neurodevelopmental Engineering Research, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China.
出版信息
Mediators Inflamm. 2023 May 8;2023:9077787. doi: 10.1155/2023/9077787. eCollection 2023.
BACKGROUND
Neonatal sepsis is an extremely dangerous and fatal disease among neonates, and its timely diagnosis is critical to treatment. This research is aimed at evaluating the clinical significance of the lymphocyte-to-C-reactive protein ratio (LCR) as an early sepsis indicator in neonates with suspected sepsis.
METHODS
Between January 2016 and December 2021, 1269 neonates suspected of developing sepsis were included in this research. Among them, sepsis was diagnosed in 819 neonates, with 448 severe cases, as per the International Pediatric Sepsis Consensus. Data related to clinical and laboratory tests were obtained via electronic medical records. LCR was calculated as total lymphocyte (109 cells/L)/C-reactive protein (mg/L). Multivariate logistic regression analysis was employed to evaluate the effectiveness of LCR as an independent indicator for determining sepsis in susceptible sepsis neonates. Receiver operating characteristic (ROC) curve analysis was conducted for investigating the diagnostic significance of LCR in sepsis. When suitable, the statistical tool SPSS 24.0 was used for statistical analyses.
RESULTS
LCR decreased significantly in the control, mild, and severe sepsis groups. Further analyses exhibited that there was a substantially greater incidence of sepsis in neonates in the low-LCR group (LCR ≤ 3.94) as opposed to the higher LCR group (LCR > 3.94) (77.6% vs. 51.4%, < 0.001). Correlation analysis indicated a substantial negative association of LCR with procalcitonin ( = -0.519, < 0.001) and hospital stay duration ( = -0.258, < 0.001). Multiple logistic regression analysis depicted LCR as an independent indicator for identifying sepsis and severe cases of this disease. ROC curve analysis indicated the optimal cutoff value of LCR in identifying sepsis to be 2.10, with 88% sensitivity and 55% specificity.
CONCLUSIONS
LCR has proven to be a potentially strong biomarker capable of identifying sepsis in a timely manner in neonates suspected to have the disease.
背景
新生儿败血症是一种极其危险和致命的疾病，及时诊断对治疗至关重要。本研究旨在评估淋巴细胞与 C 反应蛋白比值（LCR）作为疑似败血症新生儿早期败血症指标的临床意义。
方法
本研究纳入了 2016 年 1 月至 2021 年 12 月期间 1269 例疑似败血症的新生儿。其中，根据国际儿科脓毒症共识，819 例新生儿被诊断为败血症，其中 448 例为严重败血症。通过电子病历获取与临床和实验室检查相关的数据。LCR 计算方法为总淋巴细胞（109 个细胞/L）/C 反应蛋白（mg/L）。采用多变量逻辑回归分析评估 LCR 作为易感败血症新生儿败血症的独立指标的有效性。采用受试者工作特征（ROC）曲线分析探讨 LCR 在败血症中的诊断意义。合适时采用统计工具 SPSS 24.0 进行统计分析。
结果
对照组、轻度败血症组和重度败血症组的 LCR 显著降低。进一步分析表明，低 LCR 组（LCR≤3.94）新生儿发生败血症的发生率明显高于高 LCR 组（LCR＞3.94）（77.6%比 51.4%，＜0.001）。相关性分析表明，LCR 与降钙素原（ =-0.519，＜0.001）和住院时间（ =-0.258，＜0.001）呈显著负相关。多变量逻辑回归分析表明，LCR 是识别败血症和严重败血症的独立指标。ROC 曲线分析表明，LCR 识别败血症的最佳截断值为 2.10，灵敏度为 88%，特异性为 55%。
结论
LCR 是一种潜在的强大生物标志物，可及时识别疑似患有该病的新生儿的败血症。
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