摘要
目的探讨外周血血小板/淋巴细胞比值(platelet-lymphocyte ratio,PLR)与中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)联合评估老年社区获得性肺炎(community acquired pneumonia,CAP)预后的价值。方法选取2018年1月至2019年12月在我院住院治疗且符合纳入标准的老年CAP患者91例。根据患者的临床肺部感染评分(CPIS)将其分为轻症组(CPIS≤6分,n=52)和重症组(CPIS>6分,n=39)。比较两组间PLR、NLR、降钙素原(PCT)的差别;采用Spearman分析患者PLR、NLR、PCT与CPIS的相关性;观察两组患者入院后28 d内的死亡情况,用ROC曲线分析各炎症指标预测老年CAP患者28 d内死亡情况。结果重症组PLR、NLR、PCT均高于轻症组(P均<0.05);Spearman相关分析结果显示:PLR、NLR、PCT与CPIS呈正相关(r分别为0.646、0.714、0.656,P均<0.05);PLR、NLR、PCT预测老年CAP患者28 d内死亡的ROC曲线下面积分别为0.708、0.766、0.703(P均<0.05);PLR、NLR、PCT预测老年CAP患者28 d内死亡的灵敏度、特异度分别是(0.846、0.643)、(0.923、0.628)、(0.923、0.513),PLR与NLR联合预测患者28 d内死亡的灵敏度和特异度分别为0.781、0.852。结论 PLR、NLR是评估老年社区获得性肺炎患者病情严重程度的炎症指标,且PLR联合NLR可提高评估老年CAP患者预后的准确性。
Objective To discuss the prognostic value of platelet-lymphocyte ratio(PLR)combined neutrophil-lymphocyte ratio(NLR)in elderly patients with community acquired pneumonia(CAP). Methods A total of 91 elderly patients with CAP were recruited in our hospital from January 2018 to December 2019. According to their Clinical Pulmonary Infection Score(CPIS),62 cases were assigned to mild group and 39 cases to severe group. The clinical data of both groups were compared,including PLR,NLR,procalcitonin(PCT). Spearman correlation analysis was performed to investigate the correlation of PLR,NLR,PCT with CPIS. The number of death cases in both groups within 28 days of being in hospital was observed. ROC was performed to analyze the predictive value of PLR,NLR,PCT for prognosis of elderly patients with CAP,whose mortality rates within 28 days of being in hospital. Results The levels of PLR,NLR,PCT in the severe group were significantly higher than those in the mild group(P<0.05). Spearman correlation analysis showed that PLR,NLR,PCT was positively associated with CPIS(r=0.646,0.714,0.656,P all<0.05). The area under the ROC curve of PLR,NLR,PCT for predicting the mortality rate within 28 days following admission in elderly patients with CAP was 0.708、0.766 and 0.703 respectively(P all<0.05). The sensitivity,specificity of PLR,NLR,PCT for predicting the mortality rate within 28 days following admission in elderly patients with CAP were(0.846,0.643),(0.923,0.628),(0.923,0.513),respectively. The sensitivity and specificity of PLR combined with NLR in predicting 28 day death were 0.781 and 0.852. Conclusion PLR and NLR are inflammatory indicators to evaluate the severity of elderly patients with community-acquired pneumonia,and PLR combined with NLR can improve the accuracy of evaluating the prognosis of elderly patients with CAP.
作者
张玉杰
赵德根
张耀军
曹大龙
陆斌
ZHANG Yujie;ZHAO Degen;ZHANG Yaojun;CAO Dalong;LU Bin(Department of Respiration,the First People's Hospital of Bengbu,Bengbu 233000,China;Department of Laboratory,the First People's Hospital of Bengbu,Bengbu 233000,China)
出处
《宁夏医科大学学报》
2021年第9期951-954,共4页
Journal of Ningxia Medical University
