NLR、CD64及CRP对医院获得性肺炎的诊断及预后的价值分析  

Diagnostic and prognostic value of NLR、CD64 and CRP in hospital-acquired pneumonia

作　　者：商玉立[1] 郭彩霞[1] 石红梅[1] SHANG Yu-li;GUO Cai-xia;SHI Hong-mei(Henan Provincial Chest Hospital,Zhengzhou 450008,China)

机构地区：[1]河南省胸科医院呼吸科,郑州450008

出　　处：《医药论坛杂志》2020年第6期87-90,共4页Journal of Medical Forum

摘　　要：目的评估NLR、CD64及CRP对医院获得性肺炎(HAP)的诊断及预后的价值。方法随机收集2018年5月—2019年12月在河南省胸科医院呼吸科门诊体检的健康志愿者41例为健康对照组,普通呼吸科病房确诊为医院获得性肺炎患者39例为普通组,随机收集入住ICU确诊为HAP患者40例为重症组。根据出院时结局分为死亡组及生存组。比较各组NLR、CD64、CRP与SOFA评分的差异及相关性。结果普通组与重症组合并后,NLR、CD64与CRP的曲线下面积(AUC)分别为0.838、0.881、0.804,最佳诊断临界值分别为10.37、8.97%、10.21 mg/L,特异性分别为89.31%、90.34%、85.91%,敏感性分别为55.91%、66.39%、48.21%;重症组的NLR、CD64、CRP、SOFA评分明显高于普通组(P<0.05),重症组的NLR、CD64、CRP明显高于对照组(P<0.05),普通组的NLR、CD64、CRP明显高于对照组(P<0.05)。死亡组的NLR、CD64、CRP、SOFA评分明显高于生存组(P<0.01)。NLR、CD64、CRP与SOFA评分均为正相关,相关系数分别为0.81、0.86、0.62(P<0.01)。结论NLR、CD64、CRP有助于对医院获得性肺炎的诊断和预后的评估,且NLR、CD64的作用要大于CRP。Objective To assess the diagnostic and prognostic value of NLR,CD64 and CRP in hospital-acquired pneumonia(HAP).Methods Between May 2018 and December 2019,date of 41 healthy volunteers who underwent physical examination in the respiratory department of Henan Provincial Chest Hospital were randomly collected as the control group.39 patients diagnosed with HAP in the general respiratory ward were in the normal group.40 patients with HAP diagnosed in ICU were collected as severe group.According to the outcome at discharge,the patients were divided into death group and survival group.The differences and correlations between NLR,CD64,CRP and SOFA scores were compared.Results After the combination of normal group and severe group,the AUC of NLR,CD64 and CRP was 0.838,0.881 and 0.804,respectively,the optimal diagnostic threshold was 10.37,8.97%and 10.21 mg/L,respectively,the specificity was 89.31%,90.34%and 85.91%,respectively,and the sensitivity was 55.91%,66.39%and 48.21%,respectively.The NLR,CD64,CRP and SOFA scores of the severe group were significantly higher than those of the normal group(P<0.05),the NLR,CD64,and CRP scores of the severe group were significantly higher than those of the control group(P<0.05),the NLR,CD64,and CRP scores of the normal group were significantly higher than those of the control group(P<0.05),and the NLR,CD64,CRP and SOFA scores of the death group were significantly higher than those of the survival group(P<0.01).NLR,CD64,CRP and SOFA scores were positively correlated,with correlation coefficients of 0.81,0.86 and 0.62,respectively(P<0.01).Conclusion NLR,CD64 and CRP contribute to the diagnosis and prognosis assessment of HAP,and the effect of NLR,CD64 is greater than that of CRP.

关 键 词：NLR CRP SOFA CD64 医院获得性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]