ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2025, Vol. 17 ›› Issue (6): 546-552.doi: 10.20274/j.cnki.issn.1674-3865.2025.06.016

• 临床研究 • 上一篇    

中性粒细胞与白蛋白比值对儿童轻型胃肠炎伴惊厥合并可逆性胼胝体压部病变的预测价值

杨丽丽, 杨燕飞(), 王艳芬, 景玮, 胡丹梅   

  1. 030032 太原,山西白求恩医院(山西医学科学院)、山西医科大学第三医院、同济山西医院儿科(杨丽丽,杨燕飞,王艳芬),神经内科(景玮,胡丹梅)
  • 收稿日期:2025-08-18 修回日期:2025-10-17 出版日期:2025-12-25 上线日期:2025-12-31
  • 通讯作者: 杨燕飞 E-mail:yangyanfei0226@sohu.com
  • 作者简介:杨丽丽(1992-),女,医学硕士,主治医师。研究方向:儿童神经系统疾病的诊治
  • 基金资助:
    山西省科学技术委员会基金会青年科学研究项目(202403021222384)

Predictive value of neutrophil-to-albumin ratio for convulsions with mild gastroenteritis accompanied by reversible splenial lesion syndrome in children

Lili YANG, Yanfei YANG(), Yanfen WANG, Wei JING, Danmei HU   

  1. Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Third Hospital of Shanxi Medical University,Taiyuan 030032,China
  • Received:2025-08-18 Revised:2025-10-17 Published:2025-12-25 Online:2025-12-31
  • Contact: Yanfei YANG E-mail:yangyanfei0226@sohu.com
  • Supported by:
    Found program:Basic Research Programs of Science and Technology Commission Foundation of Shanxi Province(202403021222384)

摘要:

目的 探索中性粒细胞与白蛋白比值对儿童轻型胃肠炎伴惊厥(CwG)合并可逆性胼胝体压部病变(RESLES)的预测价值,为早期识别高危患儿提供参考。 方法 回顾性分析2017年1月至2025年6月山西白求恩医院儿科收治的CwG合并RESLES患儿40例为观察组,同期选取住院的CwG未合并RESLES患儿63例为对照组,对两组患儿临床特征、实验室检查结果进行分析。 结果 (1)两组在年龄、性别、体质量指数、有无发热、呕吐次数、腹泻次数、惊厥持续时间、惊厥发作频次、既往惊厥病史及家族史方面比较差异无统计学意义(P>0.05)。(2)观察组血小板计数、血钠、白蛋白低于对照组,中性粒细胞的细胞计数、C反应蛋白高于对照组,粪便轮状病毒抗原阳性检出率高于对照组,差异均有统计学意义(P<0.05)。(3)血液炎症复合指标:观察组中性粒细胞百分比/白蛋白计数(NPAR)、中性粒细胞计数×单核细胞计数/淋巴细胞计数(SIRI)、中性粒细胞计数/淋巴细胞计数(NLR)、C反应蛋白×中性粒细胞计数/淋巴细胞计数(IBI)高于对照组,差异有统计学意义(P<0.05);淋巴细胞计数×白蛋白计数/中性粒细胞计数(LANR)、白蛋白/纤维蛋白原(AFR)低于对照组,差异有统计学意义(P<0.05)。(4)多因素分析显示,NPAR及肠道轮状病毒抗原阳性为CwG合并RESLES的独立危险因素。用NPAR建立受试者操作特征(ROC)曲线,曲线下面积(AUC)为0.848,最佳截断值12.92,预测灵敏度为80.0%,特异度为74.6%。 结论 高NPAR水平及轮状病毒抗原阳性是CwG合并RESLES的独立危险因素,NPAR水平对CwG合并RESLES有一定预测价值。

关键词: 轻型胃肠炎伴惊厥, 可逆性胼胝体压部病变, 中性粒细胞, 白蛋白, 儿童

Abstract:

Objective To explore the predictive value of neutrophil-to-albumin ratio for convulsions with mild gastroenteritis (CwG) accompanied by reversible splenial lesion syndrome (RESLES) in children,and provide a reference for early identification of high-risk child patients. Methods A total of 40 patients with CwG accompanied by RESLES were retrospectively enrolled as the study group, who were treated in the Department of Pediatrics of Shanxi Bethune Hospital from January 2017 to June 2025, and 63 CwG patients without RESLES hospitalized in the same period were selected as control group. The clinical characteristics and laboratory data of the two groups were analyzed. Results (1)There were no significant differences between the study group and the control group in terms of age, gender, BMI, presence or absence of fever, number of vomiting, number of diarrhea, duration of seizures, frequency of seizures, history of previous seizures and family history(P>0.05).(2)The platelet count, blood sodium, and albumin in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05).The neutrophil count and CRP in the study group were higher than those in the control group, and the differences were statistically significant(P<0.05).The positive detection rate of fecal rotavirus antigen in the study group was higher than that in the control group, and the difference was statistically significant(P<0.05).(3)Composite indicators of blood inflammation: The neutrophil percentage/albumin count(NPAR), neutrophil count × monocyte count/lymphocyte count(SIRI), neutrophil count/lymphocyte count (NLR) and CRP × neutrophil count/lymphocyte count(IBI) in the study group were higher than those in the control group, and the differences were statistically significant(P<0.05).The lymphocyte count×albumin count/neutrophil count(LANR) and albumin/fibrinogen(AFR) in the study group were lower than those in the control group, and the differences were statistically significant(P<0.05).(4)Multivariate analysis showed that NPAR and the positivity of intestinal rotavirus antigen were independent risk factors for CwG acompanied by RESLES in children. A receiver operating characteristic curve (ROC) for NPAR yielded a 0.848 of the area under the curve, with the optimal cutoff value being 12.92, predictive sensitivity being 80.0%, and specificity being 74.6%. Conclusion High NPAR level and positive rotavirus antigen are independent risk factors for CwG acompanied by RESLES in children. The level of NPAR has certain predictive value for CwG acompanied by RESLES.

Key words: Convulsion with mild gastroenteritis, Reversible splenial lesion syndrome, Neutrophil, Albumin, Child

中图分类号: