Screening Value of Combination of LYM,PLT,NLR,LMR,LYM×PLT and CRP on Adult Influenza A with Pneumonia

CAO Fei; KONG Chengcheng; SONG Jingjing; BAI Lu; LIU Jia; HU Wanmei; SUN Chengdong

doi:10.3639/j.issn.2095-3097.2025.06.002

Abstract：Objective To explore the screening value of combination of lymphocyte(LYM),platelet(PLT),neu-trophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),lymphocyte-platelet product(LYM×PLT)and C-reactive protein(CRP)on influenza A with pneumonia in adults,and to identify a simple and reliable method for screening influenza A with pneumonia.Methods The clinical data of 287 patients with influenza A who attended the Fever Clinic of the Department of Infectious Diseases,Beijing Jishuitan Hospital,Capital Medical University from February 1 to April 30,2023,were retrospectively analyzed.The data included clinical characteristics(sex,age,underlying diseases),C-reactive protein(CRP),and routine blood test results,including white blood cells(WBC),neutrophils(NEU),lymphocytes(LYM),monocytes(MON),and platelets(PLT).The neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR)and lymphocyte times platelet(LYM×PLT)were calculated.Patients were divided into two groups based on the presence of pneumonia:the pneumonia group(138 patients)and the non-pneumonia group(149 patients).Differences in clinical features,CRP,and blood parameters were compared between the two groups.Statistically significant variables were included in binary Logistic regression analysis to establish a diagnosis model.Receiver operating characteristic(ROC)curve was used to evaluate the application value of each parameter in the screening of influenza A with pneumonia.Results The pneumonia group had older age,higher lung disease incidence,and higher diabetes incidence than the non-pneumonia group(P<0.05).Additionally,levels of NLR and CRP were significantly higher(P<0.05),while levels of LYM,PLT,LMR,and LYM×PLT were significantly lower in the pneumonia group(P<0.05).Logistic regression analysis showed thatlow LYM(OR=1.523,95%CI:1.033-2.246),low PLT(OR=1.859,95%CI:1.208-2.861),low LMR(OR=1.828,95%CI:1.182-2.799),low LYM×PLT(OR=1.861,95%CI:1.262-2.743),high NLR(OR=1.684,95%CI:1.142-2.482)and high CRP(OR=1.223,95%CI:1.015-1.473)as independent risk factors.The diagnostic equation was:Logit(P)=-7.778+1.351×LYM+0.022×PLT+0.096×CRP+0.386×NLR+1.084×LM-R+0.010×LYM×PLT.ROC curve results showed that compared with single indicators,the area under the curve(AUC)of combined diagnosis model with LYM,PLT,NLR,LMR,LYM×PLT and CRP was the largest at 0.907(95%CI:0.874-0.940).Conclusion Lower LYM,PLT,LMR,LYM×PLT and higher NLR,CRP values suggest a higher likelihood of influenza A with pneumonia.The combination of LYM,PLT,NLR,LMR,LYM×PLT and CRP has high screening value on influenza A with pneumonia.