脑梗死后遗症患者NLR、RDW和PLR变化监测在并发肺部感染防治中的应用分析  

Application analysis of NLR,RDW and PLR change monitoring in patients with sequelae of cerebral infarction in prevention and treatment of their complicated pulmonary infection

作　　者：江慧娟[1] 徐培杰 谢中秀 JIANG Huijuan;XU Peijie;XIE Zhongxiu(Zhejiang Medical Health Group Quhua Hospital,Zhejiang Quhua Hospital,Quzhou 324002,China)

机构地区：[1]浙江省医疗健康集团衢化医院,浙江衢化医院,衢州324002

出　　处：《中国免疫学杂志》2023年第2期385-388,共4页Chinese Journal of Immunology

摘　　要：目的:探讨脑梗死后遗症患者中性粒细胞/淋巴细胞比值(NLR)、红细胞分布宽度(RDW)和血小板淋巴细胞比值(PLR)变化监测在其并发肺部感染防治中的应用效果。方法:回顾性选取2018年1月至2021年8月收治的脑梗死后遗症患者95例为研究对象,均进行抗血小板、调脂、血压血糖控制、改善脑循环和抗感染等常规治疗,14 d为1个疗程,疗程间隔3 d,治疗2个疗程。比较治疗前、治疗1个疗程和治疗2个疗程NLR、RDW和PLR水平、临床肺部感染评分(CPIS)和急性生理和慢性健康评分(APACHEⅡ)。分析患者NLR、RDW和PLR水平与CPIS评分、APACHEⅡ评分的关系。统计患者住院期间肺部感染发生率。分析NLR、RDW和PLR水平、CPIS评分和APACHEⅡ评分对肺部感染发生的影响及治疗前NLR、RDW和PLR单独和联合预测脑梗死后遗症患者并发肺部感染的效能。结果:治疗前、治疗1个疗程和治疗2个疗程NLR、RDW和PLR水平、CPIS评分和APACHEⅡ评分依次降低(P<0.05)。Pearson相关分析结果显示,NLR、RDW和PLR水平与CPIS评分、APACHEⅡ评分均呈正相关(P<0.05)。脑梗死后遗症患者肺部感染发生率为16.84%(16/95)。与无肺部感染患者比较,并发肺部感染患者NLR、RDW和PLR水平、CPIS评分和APACHEⅡ评分升高(P<0.05),Logistic单因素和多因素分析结果显示,脑梗死后遗症患者NLR、RDW和PLR水平、CPIS评分和APACHEⅡ评分对肺部感染发生均具有明显影响(P<0.05)。ROC分析结果显示,脑梗死后遗症患者治疗前NLR、RDW和PLR水平单独和联合预测并发肺部感染的效能均较好,治疗前NLR、RDW和PLR水平联合预测并发肺部感染的效能最佳。结论:脑梗死后遗症患者NLR、RDW和PLR逐渐降低,与肺部感染和病情密切相关,且三者联合检测可能作为患者肺部感染早期评估的参考指标。Objective:To investigate effect of monitoring changes of neutrophil/lymphocyte ratio(NLR),erythrocyte distribution width(RDW)and platelet lymphocyte ratio(PLR)in patients with sequelae of cerebral infarction in prevention and treatment of complicated lung infections.Methods:A total of 95 patients with sequelae of cerebral infarction admitted from January 2018 to August 2021 were retrospectively selected as research objects,and treated with conventional treatments such as antiplatelet,lipid regulation,blood pressure and blood sugar control,improvement of cerebral circulation and anti-infection,14 d for a course with 3 d intervals between treatment courses,and treated for 2 courses.NLR,RDW and PLR levels,clinical lung infection score(CPIS)and acute physiology and chronic health score(APACHEⅡ)of patients before treatment,1 course of treatment and 2 courses of treatment were compared.Relationship between NLR,RDW and PLR levels with CPIS and APACHEⅡscores were analyzed.Lung infections rate during hospitalization was statistically analyzed.Effects of NLR,RDW and PLR levels,CPIS and APACHEⅡscores on occurrence of lung infection and efficacy of NLR,RDW and PLR before treatment in predicting occurrence of pulmonary infection in patients with sequelae of cerebral infarction were analyzed.Results:NLR,RDW and PLR levels,CPIS score and APACHEⅡscore before treatment,1 course of treatment and 2 courses of treatment were decreased sequentially(P<0.05).Pearson correlation analysis showed that levels of NLR,RDW and PLR were positively correlated with CPIS score and APACHEⅡscore(P<0.05).Lung infection rate in patients with sequelae of cerebral infarction was 16.84%(16/95).Compared with patients without lung infection,patients with complicated lung infection had higher levels of NLR,RDW and PLR,CPIS score and APACHEⅡscore(P<0.05).Logistic univariate and multivariate analysis showed that NLR,RDW and PLR levels,CPIS score and APACHEⅡscore of patients with sequelae of cerebral PLR before treatment in patients with sequela

关 键 词：脑梗死后遗症 NLR RDW PLR 肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统]