Clinical Significance Of Inflammatory Markers In Children's Bacterial Pneumonia

Objective:To investigate the diagnostic significance of the ratio of neutrophil to lymphocyte(NLR),platelet-lymphocyte ratio(PLR),C-reactive protein(CRP),Red blood cell distribution(RDW)and C-reactive protein and albumin ratios(CAR)in chidren with bacterial pneumonia.Methods:From Septenber 1,2016 to August 31,2017,400 children with pneumonia were divided into bacterial pneumonia group(group A,193 cases)and non-bacterial pneumonia group)(group B,207 cases).A total of 200 children with normal physical examination in YanJi Maternal and Child Health Hospital were selected as the control group.Blood routine and blood biochemical indexes were detected by automatic blood analyzer and serum CRP was detected by ELISA method Calculating the ratio of NLR,PLR and CAR,The two groups of RDW were divided into 3 different time points according to the length of stay 7 days,14 days and more than 14 days.To analyze the diagnostic significance of NLR,PLR,CRP,RDW,CAR in bacterial pneumonia and non-bacterial pneumonia.Results:1.The average values of NLR in group C and group CAP were 0.93±0.81 and 2.38±2.26.There were significant differences in the two groups(P<0.05);The average values of NLR in group A and group B were 3.49±2.53 and 1.41±1.40,and the two groups were statistically significant(P<0.05).The best NLR cut off value for diagnosing bacterial pneumonia in children was 1.491,the specificity was 75.7%,and the sensitivity was 86%.2.The average values of PLR in group C and group CAP were 99.59±55.32 and 132.66±123.62,and there were significant differences in the two groups(P<0.05).The average values of PLR in group A and group B were 146.01±96.11 and 120.18±142.67,and there were no statistical significance in the two groups(P>0.05).There was a weak correlation between the PLR level and the positive rate of bacterial and non bacterial pneumonia.3.The average values of CRP in group C and group CAP were(0.53=10.58)mg/L and(17.05±26.7)mg/L.There were significant differences in the two groups(P<0.05);The average values of CRP in group A and grou)B were(31.39±33.9)mg/L and(5.07±5.19)mg/L,and the two groups were statistically significant(P<0.05).The AUC of CRP was 91.2%.The best CRP cut off value for differential diagnosis of bacterial pneumonia in children was 7.5 mg/L.4.The average values of CAR in group A and group B were 0.75±0.86 and 0.12±0.12,and the two groups were statistically significant(P<0.05).5.The average value of RDW in the A and B grops increased with the increase in the number of days in the hospital.and there were statistical differences between the two groups at different time points(P<0.05).There was a weak correlation between the RDW level and the positive rate of bacterial and non bacterial pneumonia.Conclusion:1.The combination of NLR,PLR,CRP,RDW and CAR can be used as a reference for the differential diagnosis of bacterial and non bacterial pneumonia in children.2.The value of RDW and CAR can predict the prognosis of children with pneumonia.