摘要
目的分析壹期尘肺病合并肺部感染患者的综合血液炎症指数,探讨其对患者病情的预测价值。方法于2023年9月,选取2021年11月至2023年8月在天津市职业病防治院就诊的83例壹期尘肺病患者,根据是否合并肺部感染分为非感染组(56例)和感染组(27例),选取同期有接尘史但未诊断为尘肺病的65例工人为对照组。通过查阅病案,收集性别、年龄、职业史、既往病史、血液学化验检测等临床资料,比较各组人员综合血液炎症指数的差异,绘制ROC曲线,分析综合血液炎症指数与壹期尘肺病及其合并肺部感染的关系。结果各组患者的中性粒细胞数目(N)、淋巴细胞数目(L)、单核细胞数目(M)、C反应蛋白(CRP)、中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)、血小板/淋巴细胞比值(PLR)、全身免疫炎症反应指数(SII)、全身炎症反应指数(SIRI)、系统炎症综合指数(AISI)、衍生中性粒细胞与淋巴细胞比值(dNLR)、中性粒细胞与淋巴细胞和血小板比值(NLPR)、C反应蛋白与淋巴细胞比值(CLR)差异均有统计学意义(P<0.05),与对照组比较,非感染组患者MLR、SIRI、AISI均明显升高(P<0.05),感染组NLR、MLR、PLR、SII、SIRI、AISI、dNLR、NLPR、CLR均明显升高(P<0.05);与非感染组比较,感染组患者NLR、PLR、SII、SIRI、AISI、dNLR、NLPR、CLR明显升高(P<0.05)。ROC分析显示,NLR、MLR、PLR、SII、SIRI、AISI对壹期尘肺有一定预测能力(P<0.05),其中MLR的效能最高,其AUC为0.791(95%CI:0.710~0.873),截断值为0.18,灵敏度为71.4%,特异度为78.5%;NLR、MLR、PLR、SII、SIRI、AISI、dNLR、NLPR、CLR对壹期尘肺病合并肺部感染均有一定预测能力(P<0.05),其中CLR的效能最高,其AUC为0.904(95%CI:0.824~0.985),截断值为5.33,灵敏度为77.8%,特异度为98.2%。结论壹期尘肺病患者的综合血液炎症指数可能是其合并肺部感染的辅助预测指标。
ObjectiveTo analyze the comprehensive blood inflammation index of the patients with stage I pneumoconiosis complicated with pulmonary infection,and to explore its value in predicting the patients'disease.MethodsIn September 2023,83 patients with stage I pneumoconiosis who were treated in Tianjin Occupational Diseases Precaution and Therapeutic Hospital from November 2021 to August 2023 were selected and divided into non-infected group(56 cases)and infected group(27 cases)according to whether they were combined with lung infection.Workers with a history of dust exposure but diagnosed without pneumoconiosis during the same period were selected as the control group(65 cases).By referring to medical records and collecting clinical data such as gender,age,occupational history,past medical history,hematology testing,the differences in the comprehensive blood inflammation indexes among the three groups were compared,ROC curve was drawn,and the relationship between comprehensive blood inflammation indexes and stage I pneumoconiosis and its combined lung infection was analyzed.ResultsThere were significtant differences in the number of neutrophils(N),the number of lymphocytes(L),the number of monocytes(M),C-reactive protein(CRP),the neutrophil to lymphocyte ratio(NLR),the monocyte to lymphocyte ratio(MLR),the platelet to lymphocyte ratio(PLR),the systemic immune-inflammatory index(SII),the systemic inflammation response index(SIRI),the aggregate index of systemic inflammation(AISI),the derived neutrophil to lymphocyte ratio(dNLR),the neutrophil to lymphocyte and platelet ratio(NLPR),and the C-reactive protein to lymphocyte ratio(CLR)(P<0.05).Compared with the control group,MLR,SIRI and AISI in the non-infected group were significantly increased(P<0.05).NLR,MLR,PLR,SII,SIRI,AISI,dNLR,NLPR,CLR were significantly increased(P<0.05).Compared with the non-infected group,NLR,PLR,SII,SIRI,AISI,dNLR,NLPR and CLR were significantly increased in the infected group(P<0.05).ROC analysis showed that NLR,MLR,PLR,SII,SIRI and AISI had a
作者
刁瑛婕
华静娜
徐龙
吴琦
Diao Yingjie;Hua Jingna;Xu Long;Wu Qi(Department of Respiratory and Critical Care Medicine,Tianjin Medical University General Hospital,Tianjin 300052,China;Occupational Diseases Section,Tianjin Occupational Diseases Precaution and Therapeutic Hospital,Tianjin 300011,China;Department of Respiratory Medicine,Tianjin Haihe Hospital,Tianjin 300350,China;Science and Education Section,Tianjin Haihe Hospital,Tianjin 300350,China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2024年第5期350-355,共6页
Chinese Journal of Industrial Hygiene and Occupational Diseases
关键词
尘肺
炎症
肺部感染
合并症
预测
系统性免疫性炎症指数
系统炎症综合指数
全身炎症反应指数
Pneumoconiosis
Inflammation
Lung infection
Complications
Forecasting
Systemic immune-infammation index
Aggregate index of systemic infammation
Systemic infammation response index
