外周血SAA、NLR及BNP对COPD合并肺部感染患者预后的评估价值  

Value of Peripheral Blood SAA,NLR and BNP in Evaluating the Prognosis of Patients with COPD Complicated with Pulmonary Infection

作　　者：王月平 袁开芬[2] 王应琼[3] 孙龙 赵国厚[2] 尹飞飞[4] WANG Yueping;YUAN Kaifen;WANG Yingqiong;SUN Long;ZHAO Guohou;YIN Feifei(Department of Infectious Diseases,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,Hainan,China;Department of Respiratory Medicine,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,Yunnan,China;Department of Respiratory Medicine,the Second Affiliated Hospital of Hainan Medical College,Haikou 570100,Hainan,China;Joint Laboratory of Tropical Infectious Diseases,Hong Kong University and Hainan Medical College,Haikou 570100,Hainan,China)

机构地区：[1]海南医学院第一附属医院感染性疾病科,海南海口570102 [2]昆明医科大学第二附属医院呼吸内科,云南昆明650101 [3]海南医学院第二附属医院呼吸内科,海南海口570100 [4]海南医学院香港大学热带传染病联合实验室,海南海口570100

出　　处：《贵州医科大学学报》2020年第5期579-583,599,共6页Journal of Guizhou Medical University

摘　　要：目的:探讨外周血淀粉样物质A(SAA)、中性粒细胞/淋巴细胞比值(NLR)、脑钠肽(BNP)对慢性阻塞性肺疾病(COPD)合并肺部感染患者预后的评估价值。方法:选取99例COPD合并肺部感染患者作为合并感染组,103例单纯COPD患者为COPD组,50例同期体检健康者为对照组,比较3组受试者入院时或体检时的血清NLR、BNP及SAA水平;将COPD合并肺部感染患者根据住院期间预后再分为死亡组(n=12)与存活组(n=87),比较2组患者入院时血清NLR、BNP及SAA水平,采用Spearman法分析血清NLR、BNP、SAA水平与COPD合并肺部感染患者住院期间死亡的相关性,采用受试者工作特征曲线(ROC)线下面积(AUC)评估血清NLR、BNP、SAA水平对COPD合并肺部感染患者住院期间死亡的预测价值。结果:3组受试者血清NLR、BNP、SAA水平比较,合并感染组>COPD组>对照组,组间比较差异有统计学意义(P<0.05);死亡组患者血清NLR、BNP、SAA水平显著高于存活组,差异有统计学意义(P<0.05);Spearman相关分析结果显示,血清NLR、BNP、SAA水平与COPD合并肺部感染患者住院期间死亡均呈正相关(r=0.327、0.363、0.425,P<0.05);血清NLR、BNP、SAA联合检测对COPD合并肺部感染患者住院期间死亡的预测价值明显优于各指标单独检测(P<0.05)。结论:COPD合并肺部感染患者外周血NLR、BNP、SAA水平较单纯COPD时升高,3者联合检测对评估COPD合并肺部感染患者预后具有一定价值。Objective:To investigate the value of peripheral blood neutrophil/lymphocyte ratio(NLR),brain natriuretic peptide(BNP)and serum amyloid A(SAA)in the assessment of the prognosis of patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection(PI).Methods:99 cases of COPD with PI(Group A),103 cases of COPD(Group B)and 50 cases of healthy individuals(Group C)in our hospital were enrolled.Group A was further divided into two subgroups according to the prognosis,the death group(n=12)and the survival group(n=87).Serum NLR,BNP,and SAA levels were compared among groups and subgorups.The correlation between serum NLR,BNP,SAA and mortality of COPD patients with PI was analyzed,and the predictive value of the mortality of of COPD patients with PI while in hospital was also analyzed by Spearman correlation analysis.Results:The highest serum level of NLR,BNP,and SAA was found in Group A,followed by Group B and Group C in turn(P<0.05).The serum levels of NLR,BNP and SAA in the death group were significantly higher than those in the survival group(P<0.05).Serum NLR,BNP and SAA were positively correlated with the mortality of COPD patients with PI(P<0.05).The predictive value of combined serum NLR,BNP and SAA on mortality of COPD patients with PI as significantly better than that of the single detection(P<0.05)according to Spearman correlation analysis.Conclusion:The level of peripheral blood NLR,BNP and SAA in COPD patients with PI elevate more than that in patients with only COPD.The combined detection of the three is of great significance in the prognosis and clinical management of patients with COPD complicated with PI.

关 键 词：肺疾病 慢性阻塞性 预后 血淀粉样物质A 中性粒细胞/淋巴细胞比值 B型钠尿肽 肺部感染 评估价值 

分 类 号：R563[医药卫生—呼吸系统]