中性粒细胞淋巴细胞计数比值刘颅内细菌感染的诊断价值

目的:探讨中性粒细胞淋巴细胞计数比值(neutrophil-to-lyniphocyteratio,NLR)对颅内细菌感染的诊断价值,为颅内细菌感染的诊断提供参考。方法:共纳入100例怀疑颅内细菌感染的患者作为研究对象,所有患者均行血细胞分析及脑脊液检查,以最终脑脊液检查结果为金标准,评价NLR对颅内细菌感染的诊断价值。结果:100例怀疑颅内细菌感染的患者中,最终细菌阳性组56例(56.0%),细菌阴性组44例(44.0%)。56例颅内感染患者中,检出病原菌64株,其中革兰氏阴性菌44株,占68.75%;革兰氏阳性球菌20株,占31.25%;肺炎克雷伯菌16株,占25.00%;鲍曼氏不动杆菌10株,占15.63%是主要革兰阴性杆菌;金黄色葡萄球菌12株,占18.75%是主要革兰阳性菌3细菌阳性组NLR高于细菌阴性组,但淋巴细胞绝对值(LYM)低于细菌阴性组,差异有统计学意义(P<0.05)。WBC的AUC面积为0.504,截断值为13.98,灵敏度为44.6%,特异度为52.3%;中性粒细胞绝对值(NEUT)的AUC面积为0.519,截断值为9.88,灵敏度为46.4%,特异度为59.1%;LYM的AUC面积为0.624,截断值为1.26,灵敏度为75.0%,特异度为59.1%;NLR的AUC面积为0.757,截断值为11.79,灵敏度为89.3%,特异度为63.6%。结论:NLR检测快速、简便,且对诊断颅内细菌感染有较好的临床价值,其比值越高越倾向于细菌感染,可以指导临床用药。

Clinical application of neutrophil/lymphocyte count ratio in the diagnosis of intracranial infection

Objective:To investigate the clinical application of neutrophil/lymphocyte count ratio in the diagnosis of intracranial infection.Methods:100 patients with suspected intracranial infection were included All patients were performed blood cell analysis and cerebrospinal fluid examination.Cerebrospinal fluid examination results was as the gold standard for evaluation NLR value to the diagnosis of intracranial infection.Results:Among 100 patients,56 patients(56.0%)were bacteria positive and 44 patients(44.0%)were bacteria negative.Among the 56 cases of intracranial infection,64 strains were detected,including 44 strains of Gram-negative bacteria,68.75%,20 strains of Gram-positive bacteria,accounting for 3125%.16 strains of Klebsiella pneumoniae,accounting for 25.00% and 10 strains of Acinetobacter baumannii,accounring for 15.63% of the main Grain-negative bacilli,Staphylococcus aureus 12,accounting for 18.75%of the main Gram-positive bacteria.The NLR in bacteria positive was higher than that in bacteria negative,but LYM in bacteria positive was lower than that in bacteria negative.The difference was statistically significant(P<0.05).The WBC AUC area was 0.504,the cutoff value was 13.98,the sensitivity was 44.6%,the specificity was 52J%.The NEUT AUC area was 0.519,the cutoff value was 9.88,the sensitivity was 46.4%,the specificity was 59.1%.The LYM AUC area was 0.624,the cutoff value was 1.26,the sensitivity was 75.0%,the specificity was 59.1%.The AUC size of the NLR was 0.757,the cutoff value was 11.79,the sensitivity was 89.3%,the specificity was 63.6%.Conclusion:NLR is a simple and rapid of blood leukocyte,which is helpful in diagnosis and discrimination of intracranial infection.With the ratio higher,the more inclined to bacterial infection,which may be helpful for clinical drug use.