血清PCT、LDH及NLR在老年重症感染肺炎早期诊断及预后评估中的价值  

Value of serum PCT,LDH and NLR in the early diagnosis and prognosis evaluation of elderly severe infectious pneumonia

作　　者：田洪梅 乐涛[1] 张川[1] 姜远普[1] 刘杨 苏婕 蒲中春 TIAN Hong-mei;LE Tao;ZHANG Chuan;无(Department of Critical Care Medicine,Chengdu Third Peopleys Hospitaly,Chengdu 610000,China;Departmentof Emergency,Affiliated Hospital of Chengdu University,Chengdu 610000,China)

机构地区：[1]成都市第三人民医院重症医学科,四川成都610000 [2]成都大学附属医院急诊科,四川成都610000

出　　处：《中国实验诊断学》2020年第12期1966-1969,共4页Chinese Journal of Laboratory Diagnosis

基　　金：四川省医学会(宜昌人福)专项课题(2016ZZ002)。

摘　　要：目的探究血清降钙素原(PCT)、乳酸脱氢酶(LDH)及中性粒细胞和淋巴细胞比值(NLR)对老年重症肺炎(SP)的早期诊断及预后评估价值。方法选取老年SP患者110例(重症组)、老年普通肺炎110例(对照组),于入院24h内完成PCT、LDH、NLR检测,比较两组PCT、LDH、NLR水平,绘制受试者工作特征曲线(ROC)分析PCT、LDH及NLR对老年SP早期诊断价值;患者均按照指南行规范治疗,随访28d,评价生存状态,并采用单因素分析、多因素logistic回归分析探究影响预后危险因素,Pearson相关分析法分析PCT、LDH及NLR水平与急性生理与慢性健康(APACHEII)评分相关性。结果重症组PCT、LDH及NLR水平均显著高于对照组(P<0.05);PCT、LDH、NLR及三者联合检测诊断老年SP的ROC曲线下面积分别为0.875、0.809、0.784、0.959(P<0.05);110例患者根据28d生存状态分为死亡组39例、存活组71例;单因素分析显示,老年SP患者死亡组年龄、PCT、LDH、NLR、APACHEII评分均显著高于存活组(P<0.05);多因素logistic回归分析显示,PCT、LDH、NLR、APACHEII评分是影响老年SP死亡的危险因素(P<0.05);Pearson相关分析显示,PCT、LDH、NLR均与APACHEII评分呈正相关(P<0.05)。结论PCT、LDH及NLR水平均有助于早期诊断老年重症SP,而联合检测诊断价值更高,且PCT、LDH及NLR升高是患者死亡危险因素,与病情严重程度相关。Objective To explore the value of serum procalcitonin(PCT),lactate dehydrogenase(LDH)and neutrophil-to-lymphocyte ratio(NLR)in the early diagnosis and prognosis evaluation of elderly severe pneumonia(SP).Methods From January 2017 to December 2019,110 elderly SP patients(severe group)and 110 elderly common pneumonia patients(control group)were selected,and they completed detection of PCT,LDH and NLR within 24 hof admission.The levels of PCT,LDH and NLR of the two groups were compared,and the receiver operating characteristic curve(ROC)was drawn to analyze the value of PCT,LDH and NLR in the early diagnosis of elderly SP.Patients were given standardized treatment according to guidelines and followed up for 28 d,and the survival status was assessed,and univariate analysis and multivariate logistic regression analysis were used to explore the risk factors affecting prognosis,and Pearson correlation analysis was used to analyze the correlation between levels of PCT,LDH and NLR and Acute Physiology and Chronic Health Evaluation(APACHEII)score.Results The levels of PCT,LDH and NLR in severe group were significantly higher than those in control group(P<0.05).The areas under the ROC curves of PCT,LDH,NLR and combination of the three in diagnosing elderly SP were 0.875,0.809,0.784 and 0.959(P<0.05).110 patients were divided into death group(39 cases)and survival group(71 cases)according to the 28 dsurvival status.Univariate analysis showed that the age,PCT,LDH,NLR and APACHEII score of elderly SP patients in death group were significantly higher than those in survival group(P<0.05).Multivariate logistic regression analysis showed that PCT,LDH,NLR and APACHEII score were risk factors for the death of elderly SP(P<0.05).Pearson correlation analysis showed that PCT,LDH and NLR were all positively correlated with APACHEII score(P<0.05).Conclusion The levels of PCT,LDH and NLR are helpful for early diagnosis of elderly SP,and combined detection has higher diagnostic value.The increases of PCT,LDH and NLR are risk factors for de

关 键 词：老年 重症肺炎 降钙素原 乳酸脱氢酶 中性粒细胞和淋巴细胞比值 

分 类 号：R563.1[医药卫生—呼吸系统]