纤维蛋白原-白蛋白比率和中性粒细胞-淋巴细胞比率与儿童呼吸道合胞病毒感染严重程度的关系

Zeynep Uze Okay, Berker Okay, H. Hatipoğlu, Gülşen Akkoç, Kamil Şahin
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摘要

摘要 呼吸道合胞病毒(RSV)是呼吸道感染的常见病因。半数以上需要住院治疗的婴儿下呼吸道感染都是由它引起的。本研究旨在探讨纤维蛋白原-白蛋白比值(FAR)与 RSV 感染严重程度之间的相关性,并比较其与中性粒细胞-淋巴细胞比值(NLR)的有效性。这是一项回顾性队列研究,研究对象是本医院儿科诊所收治的 29 天至两岁的患者。患者被分为四组:第一组(轻度疾病)、第二组(中度疾病)、第三组(重度疾病)和第四组(对照组)。各组均测量了 FAR 和 NLR。第 3 组的 FAR 明显高于其他组,第 2 组高于第 1 组和第 4 组,第 1 组高于第 4 组(P0.068)。该研究确定 NLR 的临界值为≤1.49,发现严重 RSV 阳性患者的灵敏度为 62.2%,特异度为 62.2%。此外,FAR 与住院时间、治疗时间和临床好转时间之间也有统计学意义(均为 p<0.001)。NLR 与住院和治疗时间的关系不大(P<0.001)。对于感染 RSV 的儿童,FAR 可以确定疾病的严重程度和预后,以及平均住院时间、治疗时间和临床好转时间。此外,FAR比NLR更有效地预测疾病的严重程度。
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The association of fibrinogen–albumin ratio and neutrophil–lymphocyte ratio with the severity of respiratory syncytial virus infection in children
ABSTRACT Respiratory syncytial virus (RSV) is a common cause of respiratory infections. It is responsible for more than half of lower respiratory tract infections in infants requiring hospitalization. This study aimed to investigate the correlation between the fibrinogen–albumin ratio (FAR) and the severity of RSV infection and to compare its effectiveness with the neutrophil–lymphocyte ratio (NLR). This was a retrospective cohort study with patients aged from 29 days to two years who had been admitted to the pediatric clinic of our hospital. Patients were divided into four groups: group 1 (mild disease), group 2 (moderate disease), group 3 (severe disease), and group 4 (control). FAR and NLR were measured in all groups. FAR was significantly higher in group 3 than in the other groups, in group 2 than in groups 1 and 4, and in group 1 than in group 4 (p<0.001 for all). NLR was significantly higher in group 4 than in the other groups and in group 3 than in groups 1 and 2 (p<0.001 for all). FAR totaled 0.078 ± 0.013 in patients with bronchiolitis; 0.099 ± 0.028, in patients with bronchopneumonia; and 0.126 ± 0.036, in patients with lobar pneumonia, all with statistically significant differences (p<0.001). NLR showed no significant statistical differences. This study found a statistically significant increase in FAR in the group receiving invasive support when compared to that receiving non-invasive support (0.189 ± 0.046 vs. 0.112 ± 0.030; p=0.003). Mechanical ventilation groups showed no differences for NLR. FAR was used to identify severe RSV-positive patients, with a sensitivity of 84.4%, a specificity of 82.2%, and a cutoff value of >0.068. This study determined a cutoff value of ≤1.49 for NLR, with a sensitivity of 62.2% and a specificity of 62.2% to find severe RSV-positive patients. Also, statistically significant associations were found between FAR and hospitalization and treatment length and time up to clinical improvement (p<0.001 for all). NLR and hospitalization and treatment length showed a weak association (p<0.001). In children with RSV infection, FAR could serve to determine disease severity and prognosis and average lengths of hospitalization, treatment, and clinical improvement. Additionally, FAR predicted disease severity more efficiently than NLR.
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