摘要
目的探讨中性粒细胞与淋巴细胞比值(NLR)与社区获得性肺炎(Community-acquired pneumonia,CAP)严重程度评分CURB-65、PSI、A-DROP三个评分的相关性,同时比较NLR、降钙素原(PCT)与这三个评分对CAP患者死亡率预测的价值。方法回顾性分析2018年1月-2018年12月我院356例CAP患者,记录患者入院24小时内采集的NLR、PCT,在CURB-65、A-DROP、PSI三个评分不同危险分层中进行NLR、PCT差异性分析,同时分析NLR、PCT与三个评分的相关性。根据存活组与死亡组,评估NLR、PCT与三个评分对预后的判断能力用ROC曲线下面积(AUC)表示。结果相关性分析结果:NLR与入院时所有评分呈正相关(CURB-65,r=0.551;A-DROP,r=0.597;PSI,r=0.628),PCT与入院时所有评分也呈正相关(CURB-65,r=0.574;A-DROP,r=0.631;PSI,r=0.624),但NLR、PCT与三个评分之间相关性无明显差异。预后评估结果:AUC用于预测死亡率,CURB-65、A-DROP、PSI、NLR、PCT的AUC分别为0.927,0.943、0.900、0.894、0.944,PCT对死亡率的预测价值最高,其次为A-DROP评分,NLR预测价值最差。结论相比较于CAP常用评分,在基层医院NLR似乎更适合应用于对CAP病情严重程度、危险分级及预后的评估。在本研究中,相比较于欧美国家提出的两个评分,由日本提出的A-DROP评分在我国的应用效果可能更好。
Objective To investigate the correlation between neutrophil-lymphocyte ratio(NLR)and community-acquired pneumonia(CAP)severity scores(CURB-65,PSI and A-DROP),and to compare the value of NLR and procalcitonin(PCT)with these three scores in predicting the mortality of CAP patients.Methods A retrospective analysis of 356 patients with CAP at the First Affiliated Hospital of Harbin Medical University from January to December 2018 were performed.The levels of NLR and PCT were collected within 24 hours after admission,and the differences of NLR and PCT were analyzed by CURB-65,A-DROP and PSI scores of different risk stratification,and the correlation of NLR and PCT with the three scores was analyzed.According to the survival group and the death group,the ability to judge the prognosis of NLR,PCT and three scores was expressed by the area under the ROC curve(AUC).Results Correlation analysis results showed that:NLR was positively correlated with all scores at admission(CURB-65,r=0.551;A-DROP,r=0.597;PSI,r=0.628),and PCT was also positively correlated with all scores at admission(CURB-65,r=0.574;A-DROP,r=0.631;PSI,r=0.624),but there was no significant difference in the correlation between NLR and PCT and the three scores.Prognostic evaluation results showed that:AUC was used to predict mortality.The AUC of CURB-65,A-DROP,PSI,NLR,and PCT were 0.927,0.943,0.900,0.894,and 0.944,respectively.PCT had the highest predictive value for mortality,followed by A-DROP score,and NLR had the lowest prediction value.Conclusion Compared with the CAP commonly used scores,NLR in primary hospitals seems to be more suitable for the assessment of CAP severity,risk grading and prognosis.In this study,the A-DROP score proposed by Japan may be better in China than the two scores proposed by European and American countries.
作者
陈倩倩
霍建民
CHEN Qian-qian;HUO Jian-min(Department of Respiratory Medicine,the First Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang150000,China)
出处
《临床肺科杂志》
2020年第1期34-39,共6页
Journal of Clinical Pulmonary Medicine
