| 摘要: |
| ［摘要］ 目的 探讨中性粒细胞计数/淋巴细胞计数（NLR）、血清降钙素原（PCT）和乳酸水平在社区获得性肺炎（CAP）患者疾病危险度分层评估中的价值。方法 选择2018年1月至2019年12月在该院诊断为CAP的282例老年患者作为研究对象，将患者按CURB65评分≤2分为低风险组（192例），CURB65评分>2分为高风险组（90例）。采集血样后行血细胞计数，并计算NLR值，同时检测患者外周血PCT和乳酸水平。采用受试者工作特征（ROC）曲线比较NLR、PCT和乳酸诊断CAP疾病危险度分层的效能。结果 低风险组NLR、PCT和乳酸的检测值低于高风险组，差异有统计学意义（P<0.05）。NLR判别高风险CAP（重症肺炎）的截断值为13.10，其曲线下面积（AUC）为0.88。血清乳酸预测高风险CAP的截断值为2.05 mmol/L，其AUC为0.89。PCT预测高风险CAP的截断值为1.25 ng/ml，其AUC为0.95，灵敏度和特异度分别为84.40%和94.34%，约登指数为0.79。3种指标均能较好地预测CAP患者疾病危险度，以PCT为最佳预测独立因子。结论 NLR、PCT和乳酸是预测CAP病情分层的较好生物标志物，以PCT为最佳。 |
| 关键词: 中性粒细胞计数/淋巴细胞计数 降钙素原 乳酸 社区获得性肺炎 危险度分层 |
| DOI：10.3969/j.issn.1674-3806.2021.09.14 |
| 分类号:R 563.1 |
| 基金项目: |
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| Predictive value of NLR, PCT and lactic acid levels in risk stratification of community-acquired pneumonia |
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ZENG Xiao-han
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Department of Respiratory Medicine, Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Guangdong 510800, China
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| Abstract: |
| ［Abstract］ Objective To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR), serum procalcitonin(PCT) and lactic acid levels in risk stratification of community-acquired pneumonia(CAP) patients. Methods A total of 282 elderly patients diagnosed with CAP in Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2019 were selected as the study subjects. According to different CURB65 scores, the patients were divided into a low-risk group(192 cases) with CURB65 scores ≤2 points, and a high-risk group(90 cases) with CURB65 scores >2 points. After blood samples were collected, blood cells were counted and NLR value was calculated. Meanwhile, PCT and lactic acid levels in the patients′ peripheral blood were detected. Receiver operating characteristic(ROC) curve was used to compare the effectiveness of NLR, PCT and lactic acid in diagnosis of CAP disease risk stratification. Results The detection results of NLR, PCT and lactic acid in the low-risk group were significantly lower than those in the high-risk group(P<0.05). The cut-off value of NLR for distinguishing high-risk CAP(severe pneumonia) was 13.10, and the area under curve(AUC) was 0.88. The cut-off value of serum lactic acid for predicting high-risk CAP was 2.05 mmol/L, and the AUC was 0.89. The cut-off value of PCT for predicting high-risk CAP was 1.25 ng/ml, and the AUC was 0.95, and the sensitivity and specificity were 84.40% and 94.34%, respectively, with the Yorden index being 0.79. The three indicators had better prediction effects on the disease risk of CAP patients, and PCT was the best independent predictive factor. Conclusion NLR, PCT and lactic acid are better biomarkers for predicting the disease stratification of CAP, among which PCT is the best indicator. |
| Key words: Neutrophil-to-lymphocyte ratio Procalcitonin Lactic acid Community-acquired pneumonia(CAP) Risk stratification |
