目的：探讨血清C反应蛋白(CRP)/白蛋白(ALB)(CAR)、中性粒细胞/淋巴细胞计数(NLR)水平与早产儿视网膜病变(ROP)病理分期和预后的相关性分析，及其联合检测对患儿预后的预测价值。

方法：前瞻性研究。选取2022年3月至2024年9月本院出生的ROP患儿147例为ROP组，同期选取100例无ROP的早产儿为对照组。全自动生化分析仪检测血清CRP、ALB； 流式核酸荧光染色法计数中性粒细胞和淋巴细胞，并计算CAR、NLR； 采用Spearman相关分析血清CAR、NLR与ROP病变分期的关系； Logistic回归分析影响ROP患儿预后的因素； ROC曲线分析血清CAR、NLR对ROP预后的预测价值。

结果：ROP组和对照组具有可比性。ROP组患儿血清CRP、CAR、中性粒细胞计数、NLR水平显著高于对照组，ALB、淋巴细胞计数显著低于对照组(均P<0.05)； Ⅳ期ROP患儿血清CAR、NLR水平显著高于Ⅰ、Ⅱ、Ⅲ期，且Ⅰ、Ⅱ、Ⅲ期间差异显著(均P<0.05)； 血清CAR、NLR与ROP病变分期呈正相关(r=0.529、0.587，均P<0.05)，血清CAR与NLR呈正相关(r=0.546，P<0.05)； 预后不良组患儿血清CAR、NLR水平显著高于预后良好组(均P<0.001)； 血清CAR、NLR水平升高是影响ROP患儿预后的危险因素(均P<0.05)； 血清CAR、NLR以及联合检测预测ROP患儿预后的AUC分别为0.803、0.825、0.938，联合检测预测效能更佳(Z_{二者联合-CAR}=2.637，Z_{二者联合-NLR}=2.528，均P<0.05)。

结论：ROP患儿血清CAR、NLR升高，与病理分期和预后密切相关，二者联合对ROP患儿预后的预测价值更高。

METHODS:Prospective study. A total of 147 children with ROP who were born in our hospital from March 2022 to September 2024 were served as the ROP group, and 100 premature infants without ROP were served as the control group in the same period. Fully automatic biochemical analyzer was used to detect serum CRP and ALB; the flow cytometry nucleic acid fluorescence staining was used to count neutrophils and lymphocytes, and the CAR and NLR were calculated. Spearman correlation was used to analyze the relationship of serum CAR and NLR with ROP staging. Logistic regression was used to analyze the factors affecting the prognosis of children with ROP. ROC curve was drew to analyze the predictive value of serum CAR and NLR for the prognosis of ROP.

RESULTS: There was comparability between the ROP group and the control group. The ROP group had significantly higher serum CRP, CAR, neutrophil count, and NLR than the control group, and clearly lower ALB and lymphocyte count than the control group(all P<0.05). Children with stage IV ROP had clearly higher serum CAR and NLR than stages I, II, and III, and the differences among stages I, II, and III were significant(all P<0.05). Serum CAR and NLR were positively correlated with ROP staging(r=0.529, 0.587, all P<0.05), and there was a positive correlation between serum CAR and NLR(r=0.546, P<0.05). The poor prognosis group had clearly higher serum CAR and NLR than good prognosis group(all P<0.001). Elevated serum CAR and NLR were risk factors affecting the prognosis of children with ROP(all P<0.05). The AUC of serum CAR, NLR, and joint detection in predicting the prognosis of ROP children was 0.803, 0.825, and 0.938, respectively. The joint detection showed better predictive performance(Z_{combinatoion-CAR}=2.637, Z_{combinatoion-NLR}=2.528, all P<0.05).

CONCLUSION:Serum CAR and NLR are elevated in children with ROP, and they are closely related to pathological staging and prognosis. The joint detection has a higher predictive value in evaluating the prognosis of ROP.