降钙素原、中性粒细胞淋巴细胞计数比值在新生儿肺炎诊断及病情评估中的作用OA

Objective To investigate the diagnostic and prognostic value of procalcitonin(PCT)and the neutro-phil-to-lymphocyte ratio(NLR)in neonatal pneumonia.Methods A total of 160 neonates with pneumonia admitted to Ankang Maternal and Child Health Hospital between March 2020 and March 2024 were enrolled.According to the etio-logical classification,patients were divided into a bacterial pneumonia group(n=61)and a non-bacterial pneumonia group(n=99).Based on disease severity,patients were further categorized into a mild group(n=106)and a severe group(n=54).Serum PCT and NLR levels were compared between groups.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic performance of PCT and NLR,alone and in combination,for dif-ferentiating bacterial pneumonia.Multivariate logistic regression analysis was used to identify risk factors for severe pneu-monia,and ROC analysis was conducted to assess the predictive value of PCT and NLR for disease severity.Results Compared with the non-bacterial pneumonia group,the bacterial pneumonia group had significantly higher levels of PCT and NLR(P＜0.05).ROC analysis showed that the area under the curve(AUC)for PCT and NLR in diagnosing bacte-rial pneumonia was 0.776(95％CI:0.703-0.838)and 0.792(95％CI:0.721-0.850),respectively,while the combined AUC increased to 0.839(95％CI:0.773-0.892),indicating improved diagnostic performance(P＜0.05).Compared with the mild group,the severe group had significantly lower gestational age and birth weight(P＜0.05),but higher levels of PCT,NLR,white blood cell count(WBC),and C-reactive protein(CRP)(P＜0.05).Multivariate logistic regression analysis identified elevated PCT,NLR,WBC,and CRP as independent risk factors for severe neonatal pneumonia,whereas higher gestational age and birth weight were protective factors(P＜0.05).For predicting disease se-verity,the AUCs of PCT and NLR were 0.798(95％CI:0.727-0.857)and 0.794(95％CI:0.720-0.851),respec-tively.The combined PCT+NLR model and logistic regression model achieved higher predictive performance,with AUCs of 0.934(95％CI:0.884-0.967)and 0.941(95％CI:0.892-0.972),respectively(P＜0.05).Conclusion PCT and NLR demonstrate good diagnostic performance in differentiating bacterial neonatal pneumonia and are closely associat-ed with disease severity.Combined assessment of PCT and NLR provides high predictive value for severe neonatal pneu-monia.