血清ADA、NLR及RL在儿童EBV-IM早期诊断价值
The Value of Serum ADA, NLR and RL in the Early Diagnosis of EBV-IM in Children

目的：探讨血清ADA、NLR及RL在EBV-IM变化特点，为临床诊断和治疗提供依据。方法：回顾分析我院2018年1月至2024年6月的328例EBV-IM患儿(实验组)及同期入院100例非EBV-IM (对照组)的血清ADA、NLR及RL实验结果。结果：实验组ADA、RL均明显高于对照组(P < 0.01)，NLR低于对照组(P < 0.05)，血清ADA、NLR及RL诊断EBV-IM的最佳临界值分别为>30.9，0.43，8%；ROC曲线下面积为0.900、0.911、0.907，灵敏度分别为97.6%、91.5%和85.4%，特异度分别为75.0%、80.0%、和88.0%，阳性预测值分别为92.8%、93.8%和95.9%，阴性预测值分别为90.4%、74.1%和64.7%。结论：诊断EBV-IM中NLR的ROC曲线下面积最大，ADA的灵敏度和阳性预测值最高，RL特异度和阴性预测值最好，ADA、NLR及RL与EBV-IgM和EBV-DNA阳性率、肝脏受损程度具有密切关联，故血清ADA、NLR及RL联合检测，能为EBV-IM早期诊断和治疗提供依据。
Objective: To explore the characteristics of changes in serum ADA, NLR and RL in EBV-IM, so as to provide evidence for clinical diagnosis and treatment. Methods: A retrospective analysis of the serum ADA, NLR and RL experimental results of 328 children with EBV-IM in our hospital from January 2018 to June 2024 (experimental group) and 100 non-EBV-IM (control group) admitted during the same period. Results: The ADA and RL of the experimental group were significantly higher than those of the control group (P < 0.01), and the NLR was lower than that of the control group (P < 0.05). The best cut-off values for the diagnosis of EBV-IM in serum ADA, NLR and RL were >30.9, 0.43, respectively. 8%; the area under the ROC curve is 0.900, 0.911, 0.907, the sensitivity is 97.6%, 91.5%, and 85.4%, the specificity is 75.0%, 80.0%, and 88.0%, and the positive predictive value is 92.8%, 93.8, respectively % And 95.9%, the negative predictive value was 90.4%, 74.1% and 64.7%, respectively. Conclusion: The area under the ROC curve of NLR in the diagnosis of EBV-IM is the largest, the sensitivity and positive predictive value of ADA are the highest, the specificity and negative predictive value of RL are the best, the positive rate of ADA, NLR and RL and EBV-IgM and EBV-DNA, liver The degree of damage is closely related, so the combined detection of serum ADA, NLR and RL can provide a basis for early diagnosis and treatment of EBV-IM.