目的 探讨外周血单核细胞/淋巴细胞比值（monocyte-to-lymphocyte ratio, MLR）和中性粒细胞/淋巴细胞比值（neutrophil-to-lymphocyte ratio, NLR）预测儿童病毒性脑炎（viral encephalitis, VE）病情和预后的价值。 方法 回顾性分析2020年2月—2024年9月诸城市人民医院儿科收治的268例VE患儿的临床资料。根据格拉斯哥昏迷量表（Glasgow Coma Scale, GCS）评分分为危重组（≤8分，109例）和非危重组（>8分，159例），根据入院后随访6个月的儿童格拉斯哥预后量表（Glasgow Outcome Scale, GOS）结果分为预后不良组（1~3级，84例）和预后良好组（4~5级，184例）。分析影响患儿病情和预后的相关因素，评估外周血MLR和NLR预测患儿病情和预后的价值。 结果 多因素logistic回归分析显示，高中性粒细胞（neutrophil, NEU）计数、高MLR、高NLR和低LYM计数与VE患儿病情危重密切相关（P<0.05）。高NEU计数、高MLR、高NLR、低LYM计数与VE患儿预后不良密切相关（P<0.05）。受试者操作特征曲线分析显示，MLR和NLR预测VE患儿病情危重的AUC分别为0.772和0.883（P<0.05），MLR和NLR预测VE患儿预后不良的AUC分别为0.715和0.930（P<0.05）。 结论 VE患儿外周血MLR和NLR与病情危重、预后不良相关，二者可作为入院预测患儿病情和预后的生物标志物。

Objective To investigate the value of peripheral blood monocyte-to-lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR) in evaluating the severity and prognosis of pediatric viral encephalitis (VE). Methods A retrospective analysis was performed for the clinical data of 268 children with VE who were admitted to the Department of Pediatrics, Zhucheng People's Hospital, from February 2020 to September 2024. According to the Glasgow Coma Scale (GCS) score, the children were divided into critical group (109 children; GCS score ≤8) and non-critical group (159 children; GCS score >8). According to the results of Glasgow Outcome Scale after follow-up for six months, the children were divided into poor prognosis group (84 children; grade 1-3) and good prognosis group (184 children; grade 4-5). The influencing factors for disease severity and prognosis were analyzed, and the value of peripheral blood MLR and NLR in predicting disease severity and prognosis was assessed. Results The multivariate logistic regression analysis showed that high neutrophil (NEU) count, high MLR, high NLR, and low lymphocyte (LYM) count were closely associated with the critical condition and poor prognosis in children with VE (P<0.05). The receiver operating characteristic curve analysis showed that MLR and NLR had an area under the curve (AUC) of 0.772 and 0.883, respectively, for predicting critical illness in children with VE (P<0.05), as well as an AUC of 0.715 and 0.930, respectively, for predicting poor prognosis (P<0.05). Conclusions Peripheral blood MLR and NLR are associated with critical condition and poor prognosis and can be used as biomarkers for assessing the disease severity and prognosis in children with VE on admission.