| 崔舒,刘志伟,刘云,周晓琴,姚高峰,孙锋,孙龙龙.首次发作的儿童青少年抑郁障碍患者中性粒细胞与淋巴细胞比值和自杀意念的关系[J].四川精神卫生杂志,2023,36(3):216-221.Cui Shu,Liu Zhiwei,Liu Yun,Zhou Xiaoqin,Yao Gaofeng,Sun Feng,Sun Longlong,Association between neutrophil-to-lymphocyte ratio and suicidal ideation in children and adolescents with first-episode depression[J].SICHUAN MENTAL HEALTH,2023,36(3):216-221 |
| 首次发作的儿童青少年抑郁障碍患者中性粒细胞与淋巴细胞比值和自杀意念的关系 |
| Association between neutrophil-to-lymphocyte ratio and suicidal ideation in children and adolescents with first-episode depression |
| 投稿时间：2023-03-29 |
| DOI：10.11886/scjsws20230329001 |
| 中文关键词: 抑郁障碍 自杀意念 儿童 青少年 中性粒细胞与淋巴细胞比值 |
| 英文关键词:Depression Suicidal ideation Children Adolescents Neutrophil-to-lymphocyte ratio |
| 基金项目:阜阳市卫生健康委科研课题（项目名称：疫情下儿童青少年心理健康促进与应激反应研究，项目编号：FY2020xg14） |
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| 中文摘要: |
| 背景 自杀是全球严重的公共卫生问题之一。自杀与中性粒细胞与淋巴细胞比值（NLR）的关系可能在不同地区和不同年龄的人群中存在差异，有必要进一步研究NLR与我国儿童青少年抑郁障碍患者自杀意念之间的关系。目的 探讨儿童青少年抑郁障碍患者NLR与自杀意念的相关性，为探寻自杀的生物学指标提供线索。方法 回顾性纳入2020年1月-2022年12月在阜阳市第三人民医院住院治疗的536例符合《国际疾病分类（第10版）》（ICD-10）诊断标准的儿童青少年抑郁障碍患者，根据患者是否报告存在自杀意念，将患者分为两组。从病历中收集患者的人口学资料、出院诊断以及入院第二天的汉密尔顿抑郁量表17项版（HAMD-17）评分和血液学检验数据（中性粒细胞计数、淋巴细胞计数）。使用受试者操作特征曲线（ROC）测定NLR预测儿童青少年抑郁障碍患者自杀意念的最佳临界点，采用二元Logistic回归分析探索患者自杀意念的危险因素。结果 在536例患者中，无自杀意念者429例（80.04%），有自杀意念者107例（19.96%）。与无自杀意念组相比，有自杀意念组HAMD-17评分更高［（25.28±8.86）分vs.（21.21±8.46）分，F=19.400，P<0.01］，中性粒细胞水平更高［（3.85±1.68）×109/L vs.（3.15±1.14）×109/L，Z=-4.073，P<0.01］，NLR更高［（1.96±1.50）vs.（1.52±0.71），Z=-3.532，P<0.01］。ROC曲线确定的最佳临界NLR值是1.52（敏感度为59.80%，特异度为58.50%），曲线下面积为0.610。Logistic回归分析显示，在控制年龄、性别、发病年龄、病程和HAMD-17评分后，高NLR者发生自杀意念的风险是低NLR者的1.94倍（OR=1.940，95% CI：1.251~3.009，P=0.003）。结论 NLR可能是影响首次发作的儿童青少年抑郁障碍患者自杀意念的危险因素及潜在生物标志物。 |
| 英文摘要: |
| Background Suicide is one of the serious public health problems worldwide. The relationship between suicide and neutrophil-to-lymphocyte ratio （NLR） may vary in different regions and different age. It is necessary to further investigate the relationship between NLR and suicidal ideation in Chinese children and adolescents with depression.Objective To explore the correlation between NLR and suicidal ideation in children and adolescents with depression， so as to provide clues for exploring the biomarkers of suicide.Methods A retrospective analysis of 536 children and adolescents with depression who were hospitalized in the Third People's Hospital of Fuyang from January 2020 to December 2022 and met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） was performed. Patients were divided into two groups according to whether they reported suicidal ideation. Demographic data， discharge diagnosis， Hamilton Depression Scale-17 item （HAMD-17） score and hematological test data （neutrophil counts， lymphocyte counts） on the second day were collected from medical records. Receiver operating characteristic （ROC） curve was used to determine the optimal cut-off point of NLR for predicting suicidal ideation in children and adolescents with depression， and binary Logistic regression was used to analyze the risk factors for suicidal ideation.Results Among the 536 patients， 429 cases （80.04%） had no suicidal ideation， and 107 cases （19.96%） had suicidal ideation. Compared with patients without suicidal ideation， the HAMD-17 score ［（25.28±8.86） vs. （21.21±8.46）， F=19.400， P<0.01］， neutrophil level ［（3.85±1.68）×109/L vs. （3.15±1.14）×109/L， Z=4.073， P<0.01］， and NLR level ［（1.96±1.50） vs. （1.52±0.71）， Z=3.532， P<0.01］ in the suicidal ideation patients were significantly higher. The optimal critical NLR value determined by the ROC curve was 1.52 （59.80% sensitivity， 58.50% specificity）， with an area under the curve of 0.610. Logistic regression analysis showed that the risk of suicidal ideation was 1.94 times higher in those with high NLR than in the low NLR after controlling for age， sex， age at onset， duration of illness， and HAMD-17 score （OR=1.940， 95% CI： 1.251~3.009， P=0.003）.Conclusion NLR may be a risk factor and potential biomarker influencing suicidal ideation in the children and adolescents with first-episode depression. ［Funded by Scientific Research Project of Fuyang Municipal Health Commission （number， FY2020xg14）］ |
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