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    NLR和WBC联合检测在重症手足口病中的预测价值

    The predictive value of the combined detection of NLR and WBC in severe hand foot and mouth disease

      摘要
    • 摘要:
      目的应用ROC曲线及logistic回归评价中性粒细胞与淋巴细胞比值（NLR）、白细胞（WBC）联合检测对重症手足口病（hand foot and mouth disease，HFMD）的预测价值。
      方法收集HFMD 86例，其中重症44例，轻症42例，分析轻重症组间WBC、血糖（GLU）、中性粒细胞与降钙素原（PCT）、NLR、前白蛋白（PA）等临床资料，并绘制ROC曲线及进行logistic回归分析。
      结果PA、PCT、GLU、NLR、WBC在重症组与轻症组比较差异有统计学意义（P < 0.05~P < 0.01），利用ROC曲线确定NLR的最优临界值为2.252，WBC预测重症化的最优临界值为13.19×109/L，对其两个连续变量指标重新赋值后成为分类指标进行logistic多因素回归分析，发现NLR、WBC高于临界值是发生重症HFMD的独立危险因素，预测模型的回归方程为Logit（P）=-2.601+2.933X1+4.530X2，模型拟合优度检验结果显示P=0.830，>0.05。当两者联合检测，串联时预测重症HFMD的灵敏度和特异度分别为70.45%和100.00%，AUC为0.852；并联时的灵敏度和特异度分别为93.18%和88.10%，AUC为0.906。
      结论NLR与WBC联合检测对重症HFMD具有重要的临床预测价值。

       

      Abstract:
      ObjectiveTo evaluate the predictive value of the combined detection of neutrophil-to-lymphocyte ratio(NLR) and white blood count(WBC) in severe hand foot mouth disease(HFMD) by ROC curve and logistic regression.
      MethodsThe clinical data of WBC, blood glucose(GLU), neutrophils, procalcitonin(PCT), NLR and pre-albumin(PA) in 44 cases with severe HFMD and 42 cases with mild HFMD were collected, the ROC curve was drew, and the logistic regression analysis was conducted.
      ResultsThe differences of the PA, PCT, GLU, NLR and WBC between the severe group and mild group were statistically significant(P < 0.05 to P < 0.01).The ROC curve showed that the optimal threshold of NLR was 2.252, and the WBC predicted that the optimal threshold of severe change was 13.19×109/L.After two continuous variable indixes were reassigned, the results of logistic multifactor regression analysis showed that the NLR and WBC were independent risk factors of severe HFMD.The regression equation of the prediction model was Logit(P)=-2.601+2.933X1+4.530X2, and the goodness of fit test of the model showed that the P value was 0.830, which was more than 0.05.When two indictors were tested together, the sensitivity and specificity of the series predicting severe HFMD were 70.45% and 100.00%, respectively, and the AUC was 0.852.The sensitivity and specificity of the parallel predicting severe HFMD were 93.18% and 88.10%, respectively, and the AUC was 0.906.
      ConclusionThe combined detection of NLR and WBC has important clinical predictive value for severe HFMD.

       

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