痰液细菌培养联合NLR和血清IL-6检测在AECOPD诊断中的应用价值分析  

Analysis of the Clinical Value of Sputum Bacterial Culture Combined with NLR and Serum IL-6 Detection for AECOPD

作　　者：石秀芳[1] 徐元宏 SHI Xiu-fang;XU Yuan-hong(Bozhou People's Hospital,Bozhou 236800)

机构地区：[1]亳州市人民医院,236800 [2]安徽医科大学第一附属医院

出　　处：《临床输血与检验》2021年第4期511-515,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨痰细菌培养联合中性粒细胞和淋巴细胞比值(NLR)和血清白细胞介素-6(IL-6)对慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床应用价值。方法回顾性分析2018年3月~2020年2月亳州市人民医院收治的诊断明确AECOPD患者160例(痰细菌培养阴性125例,阳性35例),按照AECOPD进程中是否合并肺源性心脏病、呼吸衰竭及肺动脉高压等凶险并发症,把125例痰培养阴性患者分为单纯组(67例)和合并症组(58例)。另选35例COPD稳定期患者为对照组。比较其血常规指标和血清IL-6、超敏C反应蛋白(hs-CRP)等炎性标志物水平。结果(1)痰细菌培养阴性组、痰细菌培养阳性组与对照组三组间比较,AECOPD患者血清NLR和IL-6水平在三组的差异具有统计学意义(P<0.05);而WBC、hs-CRP、PCT的差异没有统计学意义(P>0.05)。(2)NLR水平在三组间的两两比较显示,阳性组和阴性组间的差异无统计学意义(P>0.05),但阳性组与对照组、阴性组与对照组间的差异均有统计学意义(P<0.05)。(3)IL-6表达水平在三组间的两两比较显示,阳性组与阴性组、阳性组与对照组的差异均无统计学意义(P>0.05),但阴性组与对照组间的差异均有统计学意义(P<0.05)。(4)AECOPD痰培养阴性患者中合并凶险症状组与单纯组组间比较,显示WBC、PCT、NLR、IL-6和hs-CRP表达水平差异均无统计学意义(P>0.05)。(5)各炎性指标因子在AECOPD患者痰培养阴性组的ROC曲线显示,NLR和IL-6在痰培养阴性患者的曲线下面积分别为0.720、0.689。结论痰细菌培养结果联合NLR和IL-6的表达水平可协助诊疗AECOPD患者的病情,尤其是对缺乏特异性指标的痰细菌培养阴性的AECOPD患者。Objective To investigate the clinical value and significance of sputum culture combined with granulocytic ratio(NLR)and interleukin-6(IL-6)in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients.Methods Retrospective analysis of 160 AECOPD patients(125 sputum culture-negative cases and 35 sputum culture-positive cases)in Bozhou people's Hospital admitted and diagnosed March 2018~February 2020 was performed.According to whether the AECOPD process with pulmonary heart disease,respiratory failure or pulmonary hypertension or other dangerous complications,the 125 patients with negative sputum culture were divided into simple group(67 cases)and complicated group(58 cases).Another 35 COPD stable patients were selected as control group.Comparison of blood routine and serum IL-6、hs-CRP,the general clinical data and laboratory indexes were collected and analyzed.Results(1)Comparisons among three groups,there were significantly differences in NLR and IL-6 levels(P<0.05),but no statistical difference in other indicators(P>0.05).(2)NLR in pairwise comparisons among three groups:comparison of AECOPD sputum culture negative group and positive group,we found that there was no statistical difference(P>0.05),but comparison with the control group,AECOPD sputum culture-negative group and positive group showed significant differences(P<0.05).(3)IL-6 level in pairwise comparisons in three groups:comparison with AECOPD sputum culture positive-group,AECOPD sputum culture negative group and the control group showed no statistical difference(P>0.05),but there was a significant difference between AECOPD sputum culture negative group and the control group(P<0.05).(4)In the AECOPD sputum culture-negative cases,there was no statistical significance between complicated group and simple group.(5)The ROC curve analysis of each inflammatory index factor in the sputum culturenegative group of AECOPD patients showed that the area of NLR and IL-6 under the curve of sputum culture negative patients was 0.720

关 键 词：中性粒细胞和淋巴细胞比值 白细胞介素-6 慢性阻塞性肺疾病 痰细菌培养 

分 类 号：R446.1[医药卫生—诊断学]