感染性荨麻疹腹痛与中性粒细胞/淋巴细胞比值及血小板/淋巴细胞比值的关系
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摘要
目的分析急性荨麻疹腹痛患者在合并感染及无感染的情况下,超敏C-反应蛋白(hs-CRP)水平、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)的变化与急性荨麻疹腹痛的关系。方法选取该院急性荨麻疹腹痛患者100例,按患者有无感染,分为感染性荨麻疹腹痛组(感染组)和非感染性荨麻疹腹痛组(非感染组),每组50例。另随机选取同期于该院就诊的其他原因导致的急性荨麻疹不伴腹痛患者50例作为对照组。测定3组患者的hs-CRP、NLR、PLR水平,利用受试者工作特征曲线(ROC曲线)进行灵敏度与特异度分析。结果感染组患者hs-CRP水平、NLR、PLR高于非感染组和对照组,差异均有统计学意义(P<0.05),而非感染组和对照组各指标比较差异无统计学意义(P>0.05)。hs-CRP用于感染性荨麻疹腹痛诊断的ROC曲线下面积(AUC)为0.997,最佳诊断值为13.56mg/L,灵敏度为96%,特异度为80%。NLR对感染性荨麻疹腹痛ROC曲线下AUC为0.843,最佳诊断值为17.67,灵敏度为70%,特异度为88%。PLR对感染性荨麻疹腹痛ROC曲线下AUC为0.974,最佳诊断值为224.85,灵敏度为94%,特异度为92%。结论 hsCRP、NLR和PLR水平对感染性荨麻疹腹痛的诊断均具有较高的灵敏度和特异度,值得进行临床推广使用。
Objective To analyze the relationship between the changes of hs-CRP concentration,NLR and PLR in patients with infectious urticaria and abdominal pain.Methods Totally 100 patients of acute urticaria with abdominal pain were enrolled in the study and divided into 2 groups:infected group(n=50)and noninfected group according to whether they were infected or not.Another 50 patients with acute urticaria without abdominal pain due to other causes were randomly enrolled as the control group.The levels of hs-CRP,NLR and PLR in the three groups were measured,and the sensitivity and specificity were analyzed by the receiver operating(ROC)curve.Results The hs-CRP concentration,NLR and PLR of infected group were significantly higher than those of noninfected group and control group(P<0.05),but there was no significant difference between the noninfected group and the control group(P>0.05).The AUC of ROC curve of hs-CRP for the diagnosis of infectious urticaria abdominal pain was 0.997,the best diagnostic value was 13.56 mg/L,the sensitivity was 96%,the specificity was 80%.The AUC of NLR was 0.843,the best diagnostic value was 17.67,the sensitivity was 70%,and the specificity was 88%.The AUC of PLR was 0.974,the best diagnostic value was 224.85,the sensitivity was 94%,and the specificity was 92%.Conclusion The plasma hs-CRP concentration,NLR and PLR are highly sensitive and specific for infectious urticaria with abdominal pain,which is worthy of clinical promotion.
Objective To analyze the relationship between the changes of hs-CRP concentration,NLR and PLR in patients with infectious urticaria and abdominal pain.Methods Totally 100 patients of acute urticaria with abdominal pain were enrolled in the study and divided into 2 groups:infected group(n=50)and noninfected group according to whether they were infected or not.Another 50 patients with acute urticaria without abdominal pain due to other causes were randomly enrolled as the control group.The levels of hs-CRP,NLR and PLR in the three groups were measured,and the sensitivity and specificity were analyzed by the receiver operating(ROC)curve.Results The hs-CRP concentration,NLR and PLR of infected group were significantly higher than those of noninfected group and control group(P<0.05),but there was no significant difference between the noninfected group and the control group(P>0.05).The AUC of ROC curve of hs-CRP for the diagnosis of infectious urticaria abdominal pain was 0.997,the best diagnostic value was 13.56 mg/L,the sensitivity was 96%,the specificity was 80%.The AUC of NLR was 0.843,the best diagnostic value was 17.67,the sensitivity was 70%,and the specificity was 88%.The AUC of PLR was 0.974,the best diagnostic value was 224.85,the sensitivity was 94%,and the specificity was 92%.Conclusion The plasma hs-CRP concentration,NLR and PLR are highly sensitive and specific for infectious urticaria with abdominal pain,which is worthy of clinical promotion.
引文
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[2] POURAFKARI L,WANG C K,TAJLIL A,et al.platelet-lymphocyte ratio in prediction of outcome of acute heart failure[J].Biomark Med,2018,12(1):63-70.
[3] CANNON N A,MEYER J,IYENGAR P,et al.Neutrophil-lymphocyte and platelet-lymphocyte ratios as prognostic factors after stereotactic radiation therapy for early-stage non-small-cell lung cancer[J].J Thorac Oncol,2015,10(2):280-285.
[4]COBAN A M,AKSOY E,DUMAN D,et al.Does eosinophilia and neutrophil to lymphocyte ratio affect hospital re-admission in cases of COPD exacerbation[J].Tuberk Toraks,2017,65(4):282-290.
[5]张学军.皮肤性病学[M].北京:人民卫生出版社,2002.95.
[6]尚红,王毓三,申子瑜.全国临床检验操作规程[M].4版.北京:人民卫生出版社,2014:170.
[7]马步青.降钙素原和C反应蛋白检测在急性荨麻疹中价值的初步研究[D].杭州:浙江大学,2016.
[8] MORTUREUX P,LEAUTE-LEBREZE C,LEGRAINLIFERMANN V,et al.Acute urticaria in infancy and early childhood:aprospective study[J].Archives of Dematology,1998,134(3):319-323.
[9]倪高顺,牛永亮,陈洋.PLR、NLP水平和C反应蛋白在预测慢阻肺急性加重的价值分析[J].临床肺科杂志,2016,21(11):2032-2035.
[10]BALTA S,APARCI M,OZTURK C,et al.Mean platelet volume as one part of platelet function determining inflammation[J].Ann Saudi Med,2016,36(3):234.
[11]林春玲,赵延明.老年感染诱发性急性荨麻疹患者的临床特征研究[J].实用老年医学,2016,30(4):323-325.