摘要
目的探讨白细胞介素-6(IL-6)、C-反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)和N末端前脑钠肽前体(NT-proBNP)对老年心力衰竭(以下简称心衰)合并肺炎的诊断价值。方法选取2022年4月至2023年4月该院收治的165例老年心衰患者作为研究对象,根据是否合并肺炎分为心衰合并肺炎组(78例)和单纯心衰组(87例),根据美国纽约心脏病协会(NYHA)心功能分级标准分为Ⅱ级组(59例)和Ⅲ级+Ⅳ级组(106例)。比较各组IL-6、CRP、NT-proBNP水平和NLR;采用Spearman相关分析IL-6、CRP、NLR与NT-proBNP水平的相关性;采用受试者工作特征(ROC)曲线评估IL-6、CRP、NLR、NT-proBNP单独及联合检测对心衰患者合并肺炎的诊断效能。结果心衰合并肺炎组IL-6、CRP、NT-proBNP水平及NLR明显高于单纯心衰组(P<0.05),Ⅲ级+Ⅳ级组IL-6、CRP、NT-proBNP水平及NLR明显高于Ⅱ级组(P<0.05)。Spearman相关性分析结果显示,NT-proBNP水平与IL-6、CRP、NLR水平呈正相关(r=0.263、0.419、0.468,P<0.001)。IL-6、CRP、NLR和NTproBNP联合诊断心衰合并肺炎的曲线下面积(AUC)为0.726(95%CI:0.650~0.803),灵敏度为67.9%,特异度为71.3%。结论心衰合并肺炎患者IL-6、CRP、NT-proBNP水平和NLR明显高于单纯心衰患者,上述4项指标联合检测对心衰合并肺炎患者有一定的诊断效能。
Objective To investigate the diagnostic value of interleukin-6(IL-6),C-reactive protein(CRP),neutrophil-to-lymphocyte ratio(NLR)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)in elderly patients with heart failure(HF)combined with pneumonia.Methods A total of 165 elderly patients with HF admitted to the hospital from April 2022 to April 2023 were selected as the study subjects,and which were divided into the HF combined with pneumonia group(78 cases)and the HF group(87 cases)according to whether or not they were combined with pneumonia,classⅡgroup(59 cases)and classⅢ+Ⅳgroup(106 cases)according to the cardiac function classification standard of the New York Heart Association(NYHA)of the United States.The levels of IL-6,CRP,NT-proBNP and NLR were compared between different groups.Spearman′s correlation was used to analyze the correlation between NT-proBNP level and the levels of IL-6,CRP and NLR.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic effects of IL-6,CRP,NLR and NT-proBNP alone and in combination on HF combined with pneumonia.Results The levels of IL-6,CRP,NT-proBNP and NLRin the HF combined with pneumonia group were significantly higher than those in the HF group(P<0.05);the levels of IL-6,CRP,NT-proBNP and NLR in the classⅢ+Ⅳgroup were significantly higher than those in the classⅡgroup(P<0.05).The results of the Spearman′s correlation analysis showed that NT-proBNP level was positively correlated with IL-6,CRP levels and NLR(r=0.263,0.419,0.468,P<0.001).The area under the curve(AUC)for the combined diagnosis of IL-6,CRP,NLR and NTproBNP was 0.726(95%CI:0.650-0.803),with a sensitivity of 67.9%and a specificity of 71.3%.Conclusion The levels of IL-6,CRP,NT-proBNP and NLR in patients with HF and pneumonia were significantly higher than those in patients with HF alone,and the combination of the above four indexes has certain diagnostic efficacy in patients with HF and pneumonia.
作者
吴政燮
韩才均
崔海霞
朴美花
WU Zhengxie;HAN Caijun;CUI Haixia;PIAO Meihua(Department of Laboratory,Yanbian University Hospital,Jilin,Yanji 133000,China)
出处
《检验医学与临床》
CAS
2024年第9期1250-1253,1258,共5页
Laboratory Medicine and Clinic
基金
延边大学应用基础项目(ydkj202230)。
