摘要
目的探讨外周血降钙素原(PCT)、中性粒细胞/淋巴细胞比值(NLR)、全身免疫炎症指数(SII)联合临床肺部感染评分(CPIS)在脑卒中后肺部感染诊断及预后评估中的价值。方法选取洛阳市第六人民医院2020年5月至2023年3月收治的126例脑卒中患者,根据是否发生肺部感染将其分为感染组(65例)与非感染组(61例)。记录所有患者外周血PCT、NLR、SII以及CPIS评分,采用受试者工作特征(ROC)曲线分析上述指标对脑卒中后肺部感染、预后的预测价值。结果感染组外周血PCT、NLR、SII以及CPIS评分均高于非感染组(P<0.05);ROC曲线分析显示,外周血PCT、NLR、SII、CPIS评分以及联合对脑卒中后肺部感染均有预测效能(P<0.05),其曲线下面积(AUC)分别为0.892、0.955、0.959、0.923、0.985,其中联合效能最高,敏感度为98.46%,特异度为100.00%。外周血PCT、NLR、SII以及CPIS评分均为预后良好组<预后不良组<死亡组(P<0.05);ROC曲线分析显示,外周血PCT、NLR、SII、CPIS评分以及联合对脑卒中后肺部感染预后均有预测效能(P<0.05),其AUC分别为0.631、0.651、0.668、0.750、0.849,其中联合效能最高,敏感度为75.00%,特异度为100.00%。结论外周血PCT、NLR、SII以及CPIS评分在脑卒中后肺部感染诊断及预后评估中均具有较高的诊断效能,但联合诊断效能最高。
Objective To explore the value of peripheral blood procalcitonin(PCT),neutrophil/lymphocyte ratio(NLR),systemic immunoinflammatory index(SII)combined with clinical pulmonary infection score(CPIS)in the diagnosis and prognosis assessment of post-stroke pulmonary infection.Methods A total of 126 patients with stroke admitted to Luoyang Sixth People’s Hospital from May 2020 to March 2023 were selected and divided into infected group(65 cases)and non-infected group(61 cases)according to whether pulmonary infection occurred.The peripheral blood PCT,NLR,SII and CPIS score of all patients were recorded,and the predictive value of the above indicators on post-stroke pulmonary infection and prognosis was analyzed by receiver operating characteristic(ROC)curve.Results The peripheral blood PCT,NLR,SII and CPIS score in infected group were higher than those in non-infected group(P<0.05).ROC curve analysis showed that peripheral blood PCT,NLR,SII and CPIS score and their combination had predictive efficiency on post-stroke pulmonary infection(P<0.05),and their area under the curve(AUC)were 0.892,0.955,0.959,0.923 and 0.985 respectively.The combined detection had the highest efficiency,with sensitivity of 98.46%and specificity of 100.00%.The peripheral blood PCT,NLR,SII and CPIS score were manifested as good prognosis group<poor prognosis group<death group(P<0.05).ROC curve analysis revealed that peripheral blood PCT,NLR,SII and CPIS score and their combination were effective in predicting the prognosis of post-stroke pulmonary infection(P<0.05),and their AUC were 0.631,0.651,0.668,0.750 and 0.849 respectively,and the combination efficiency was the highest with sensitivity of 75.00%and specificity of 100.00%.Conclusion Peripheral blood PCT,NLR,SII and CPIS score have high diagnostic efficiency in the diagnosis and prognosis assessment of post-stroke pulmonary infection,but the combined diagnosis has the highest efficiency.
作者
廖原
索广慧
张博
LIAO Yuan;SUO Guanghui;ZHANG Bo(Intensive Care Medicine,Luoyang Sixth People’s Hospital,Luoyang 471003,China)
出处
《河南医学研究》
2025年第13期2374-2377,共4页
Henan Medical Research
