摘要
目的探讨传统炎性标志物在成人急性上呼吸道感染(URTI)诊断中的应用价值。方法回顾性分析2022年1月至2023年9月在厦门大学附属妇女儿童医院就诊的243例成人URTI的临床资料,以感染病原体类型为依据将其分为细菌感染组(n=87)、病毒感染组(n=122)、支原体感染组(n=34),对比三组的中性粒细胞与淋巴细胞比值(NLR)、红细胞分布宽度(RDW)、血小板计数(PLT)、平均血小板体积(MPV)、C反应蛋白(CRP)水平;根据炎症反应时间将所有患者分为小于6 h组(n=79)和大于6 h组(n=164),评估NLR、MPV、CRP对不同时相的细菌性URTI的预测价值。结果细菌感染组的NLR、CRP均明显高于病毒感染组和支原体组,差异均具有统计学意义(均P<0.05);细菌感染组的MPV高于病毒感染组,差异有统计学意义(P<0.05),而与支原体感染组相比,差异无统计学意义(P>0.05)。ROC曲线分析,NLR、MPV、CRP诊断炎症反应时间小于6 h的细菌性URTI的曲线下面积(AUC)分别为0.786(95%CI 0.687~0.884,P<0.001)、0.533(95%CI 0.393~0.674,P=0.625)、0.694(95%CI 0.576~0.813,P=0.004),而诊断炎症反应时间大于6 h的细菌性URTI的曲线下面积(AUC)分别为0.748(95%CI 0.673~0.824,P<0.001)、0.622(95%CI 0.529~0.714,P=0.010)、0.730(95%CI 0.649~0.811,P<0.001)。结论传统炎性标志物NLR、MPV和CRP均有助于细菌性URTI及非细菌性URTI的鉴别诊断,且NLR具有更快的反应速度;三种指标均可为URTI的类型判断提供一定的参考,以指导临床用药。
Objective To investigate the value of traditional inflammatory markers in the diagnosis of acute upper respiratory tract infection in adults.Methods The clinical data of 243 adults with acute upper respiratory tract infection treated in Women and Children’s Hospital,School of Medicine,Xiamen University from January 2022 to September 2023 were retrospectively analyzed.According to the types of infectious pathogens,they were divided into bacterial infection group(n=87),viral infection group(n=122)and mycoplasma infection group(n=34).Neutrophil to lymphocyte ratio(NLR),red blood cell distribution width(RDW),platelet count(PLT),mean platelet volume(MPV)and C-reactive protein(CRP)levels were compared among the three groups.All patients were divided into less than 6h group(n=79)and more than 6h group(n=164)according to the inflammatory response time,and the predictive value of NLR,MPV and CRP in different simultaneous phases of bacterial hypersensitivity was evaluated.Results NLR and CRP in bacterial infection group were significantly higher than those in viral infection group and mycoplasma group,with statistical significance(all P<0.05).The MPV of the bacterial infection group was higher than that of the viral infection group,the difference was statistically significant(P<0.05),but the difference was not statistically significant compared with the mycoplasma infection group(P>0.05).ROC curve analysis showed that the area under the curve(AUC)of NLR,MPV,and CRP for diagnosing bacterial hypersensitivity with an inflammatory response time of less than 6 hours were 0.786(95%CI 0.687-0.884,P<0.001),0.533(95%CI 0.393-0.674,P=0.625),0.694(95%CI 0.576-0.813,P=0.004),respectively,while the AUC for diagnosing bacterial hypersensitivity with an inflammatory response time of more than 6 hours was 0.748(95%CI 0.673-0.824,P<0.001),0.622(95%CI 0.529-0.714,P=0.010),0.730(95%CI 0.649-0.811,P<0.001),respectively.Conclusions Traditional inflammatory markers NLR,MPV,and CRP are all helpful in the differential diagnosis of bacterial and
作者
林益娟
陈丽锦
LIN Yijuan;CHEN Lijin(Department of Emergency,Women and Children’s Hospital,School of Medicine,Xiamen University,Xiamen 361003,China;Department of Clinical Laboratory,Women and Children’s Hospital,School of Medicine,Xiamen University,Xiamen 361003,China)
出处
《中国医药指南》
2024年第12期66-69,共4页
Guide of China Medicine
