The application of lymphocyte*platelet and mean platelet volume/platelet ratio in influenza A infection in children

Abstract

Background: To explore the characteristics and regularity of complete blood count (CBC) changes among influenza A-positive child patients and to discover parameters that can help with the diagnosis and differential diagnosis.

Methods: One hundred and ninety-one influenza A-positive children, two hundred and nineteen influenza A-negative children with influenza-like symptoms, and two hundred and forty-seven healthy children were included in this study. They were divided into three groups: influenza A-positive patient group, influenza A-negative patient group, and control group. Reverse transcriptase polymerase chain reaction testing and Sysmex XS-800i hematology analyzer were used to obtain influenza A and CBC results, respectively. CBC along with parameters including lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume/platelet ratio (MPV/PLT), and lymphocyte*platelet (LYM*PLT) was calculated and recorded for each child. The differences in these parameters among different groups were tested with SPSS 15.0. The diagnostic values were also evaluated.

Results: The LYM and PLT of child patients with influenza A were significantly lower than those of both influenza A-negative patients with influenza-like symptoms and healthy controls. Among all the parameters, LYM*PLT has the largest area under the curve and the highest diagnostic value, followed by MPV/PLT. Compared with using LMR or MPV/PLT, the diagnostic value of using LYM alone was, on the contrary, higher.

Conclusions: Low LYM*PLT and high MPV/PLT may indicate influenza A infection in children with influenza-like symptoms, which can be a useful indicator for diagnosis and differentiation of influenza A infection.

Keywords: influenza A; lymphopenia; mean platelet volume; thrombocytopenia.

Figure 1

A, Distributions of lymphocyte (LYM); B, platelet (PLT); C, mean platelet volume (MPV); D, lymphocyte‐to‐monocyte ratio (LMR); E, MPV/PLT; and F, LYM*PLT in the influenza A–positive patient group, the influenza A–negative patient group, and the control group

Figure 2

Receiver operating characteristic (ROC) curve of lymphocyte (LYM), platelet (PLT), mean platelet volume (MPV), lymphocyte‐to‐monocyte ratio (LMR), MPV/PLT, and LYM*PLT in influenza A. A, The influenza A–negative patient group was used as reference; B, the control group was used as reference