中性粒细胞与淋巴细胞计数比值、C反应蛋白和降钙素原在重症肺部感染患者中的早期诊断及预后评估价值  

The value of NLR,CRP and PCT in clinical diagnosis and prognosis of severe pulmonary infection

作　　者：王刚[1] 吴剑锋[1] WANG Gang;WU Jian-feng(Department of Clinical Laboratory,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,Jiangsu,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)医学检验科,南京210006

出　　处：《东南国防医药》2021年第6期596-599,共4页Military Medical Journal of Southeast China

摘　　要：目的探讨炎症指标中性粒细胞与淋巴细胞计数比值(NLR)、C反应蛋白(CRP)和降钙素原(PCT)对重症肺部感染患者早期诊断及预后评估的价值。方法回顾性分析2019年1月至2020年10月南京医科大学附属南京医院收治的重症肺部感染患者46例(重症组)的临床资料,选取同期普通肺部感染患者46例作为对照组。对比分析2组患者治疗前及治疗后7 d的NLR、CRP和PCT水平,随访30 d,统计重症肺部感染患者预后情况。结果重症组治疗前NLR、CRP及PCT水平显著高于对照组(P<0.05);受试者工作特征(ROC)曲线分析显示NLR对重症组诊断灵敏度为78.26%,特异性为71.74%;CRP对重症组诊断灵敏度为93.48%,特异性为69.57%;PCT对重症组诊断灵敏度为95.65%,特异性为76.09%;三者联合诊断敏感度为灵敏度为98.13%,特异性为90.05%,高于单独诊断(P<0.05);随访结果显示死亡者NLR、CRP及PCT的水平均显著高于部分缓解者和完全缓解者(P<0.05);而部分缓解者NLR、CRP及PCT的水平均显著高于完全缓解者(P<0.05)。结论NLR、CRP和PCT对于重症肺部感染的临床诊断及预后情况评估均具有一定的应用价值,其中PCT具有较高的临床参考价值,且NLR+CRP+PCT联合检测能够提高重症肺部感染的诊断灵敏度,具有较高的临床预测价值,为指导临床治疗提供了有效的实验诊断依据。Objective To investigate the value of inflammatory markers including the ratio of neutrophils to lymphocyte count(NLR),C-reactive protein(CRP)and procalcitonin(PCT)in early diagnosis and prognosis of patients with severe pulmonary infection.Methods Forty-six patients with severe pulmonary infection who were treated in our hospital from January 2019 to October 2020 were enrolled.Forty-six patients with concurrent common pulmonary infection were enrolled as the control group.The levels of NLR,CRP and PCT of all patients were measured before and after treatment.Patients were followed up for 30 days and their prognosis was evaluated.Results The levels of NLR,CRP and PCT in the patients with severe pulmonary infection before treatment were significantly higher than those in the control group(P<0.05).ROC curve analysis showed that the diagnostic sensitivity and specificity of NLR were 78.26%and 71.74%,respectively.The diagnostic sensitivity and specificity of CRP in patients with severe pulmonary in-fection were 93.48%and 69.57%,respectively.The diagnostic sensitivity and specificity of PCT in patients with severe pulmonary infection were 95.65%and 76.09%,respectively.The combined detection of NLR,CRP and PCT levels improved the diagnostic sensitivity and specificity to 98.13%and 90.05%(P<0.05).Follow-up results showed that the levels of NLR,CRP and PCT in the death group were significantly higher than those in the partial response group and the complete response group(P<0.05).The levels of NLR,CRP and PCT in the partial remission group were significantly higher than those in the complete remission group(P<0.05).Conclusion NLR,CRP and PCT have certain application value in clinical diagnosis and prognosis evaluation of severe pulmonary infection,among which PCT has high clinical reference value and provides effective experimental diagnostic basis for guiding clinical treatment.In addition,the combined detection of NLR,CRP and PCT levels significantly improve the diagnostic value which will provide valuable information f

关 键 词：重症肺部感染 中性粒细胞与淋巴细胞计数比值 C反应蛋白 降钙素原 

分 类 号：R563.1[医药卫生—呼吸系统]