重症肺炎患者预后与中性粒细胞/淋巴细胞比值、降钙素原水平的相关性分析  

Correlation of Prognosis with Neutrophil/Lymphocyte Ratio and Procalcitonin Level in Patients with Severe Pneumo⁃nia

作　　者：程涛[1] CHENG Tao(Department of Respiratory and Critical Care Medicine,Nanyang First People’s Hospita,Nanyang,Henan,473000,China)

机构地区：[1]南阳市第一人民医院呼吸与危重症医学科,河南南阳473000

出　　处：《黑龙江医学》2022年第14期1675-1677,共3页Heilongjiang Medical Journal

摘　　要：目的:分析重症肺炎患者预后与中性粒细胞/淋巴细胞(NLR)比值、降钙素原(PCT)水平的相关性。方法:选取南阳市第一人民医院2018年6月—2020年2月将治的152例重症肺炎患者作为研究对象,根据入院1个月生存情况分为生存组87例,死亡组65例,入院1 d检测血清PCT、血乳酸(Lac)、肝肾功能、血常规,评估急性生理学与慢性健康评分Ⅱ(APACHEⅡ),计算氧合指数(PaO2/FiO2)及NLR,分析入院后3 d内变化趋势,通过单因素及多因素分析评估重症肺炎预后的影响因素。结果:生存组白细胸计数(WBC)、NLR、血清PCT、Lac、APACHEⅡ评分均低于死亡组,差异有统计学意义(t=2.277、12.361、10.174、7.726,9.990,P<0.05)。入院1 d、2 d、3 d生存组血清PCT、Lac、NLR、APACHEⅡ评分均低于死亡组,差异有统计学意义(P<0.05)。血清PCT(95%CI为1.103~1.946,OR=1.465)、Lac(95%CI为1.225~1.833,OR=1.498)、NLR(95%CI为1.018~2.352,OR=1.547)、APACHEⅡ评分(95%CI为1.094~2.137,OR=1.529)较高是重症肺炎患者死亡的独立危险因素,差异有统计学意义(P<0.05)。结论:血清PCT、Lac、NLR、APACHEⅡ评分较高是重症肺炎患者死亡的独立危险因素,临床可通过及早检测评估患者预后,对预后较差患者进行重点关注。Objective:To analyze the correlation of prognosis with neutrophil/lymphocyte ratio(NLR)and procalcitonin(PCT)level in patients with severe pneumonia.Methods:A total of 152 patients with severe pneumonia in the hospital from June 2018 to February 2020 were selected,and they were divided into a survival group of 87 cases and a death group of 65 cases according to their one-month survival conditions.On the 1st day of admission,serum PCT,blood lactate(Lac),liver and kidney function,blood routine were detected,acute physiology and chronic health score II(APACHE II)were evaluated,and oxygenation index(PaO2/FiO2)and NLR were calculated.The change trend within 3 d after admission was analyzed,and the influencing factors of the prognosis of severe pneumonia were evaluated by univariate and multivariate analysis.Results:The scores of WBC,NLR,serum PCT,Lac,and APACHE II in the survival group were lower than those in the death group,and the difference was statistically sig⁃nificant(t=2.277,12.361,10.174,7.726,9.990,P<0.05).The serum PCT,Lac,NLR,and APACHE II scores of the survival group were lower than those of the death group on the 1st,2nd,and 3rd d of admission,and the differences were statistically significant(P<0.05).Higher serum PCT(95%CI:1.103-1.946,OR=1.465),Lac(95%CI:1.225-1.833,OR=1.498),NLR(95%CI:1.018-2.352,OR=1.547),APACHE II score(95%CI:1.094-2.137,OR=1.529)were independent risk factors for death in patients with severe pneumonia,and the difference was statistically significant(P<0.05).Conclusion:Higher serum PCT,Lac,NLR,and APACHE II scores are independent risk factors for death in patients with severe pneumonia.Early detection can be used to assess the prognosis of patients,and patients with poor prognosis should be paid more attention.

关 键 词：重症肺炎 预后 中性粒细胞/淋巴细胞比值 降钙素原 

分 类 号：R375.2[医药卫生—病原生物学]