降钙素原和中性粒细胞与淋巴细胞计数比值对脓胸的诊断价值评价  

Evaluation of the diagnostic value of procalcitonin and neutrophil-lymphocyte ratio in pyothorax

作　　者：姜贺果 高蕾 魏森宇 丁明[1] JIANG Heguo;GAO Lei;WEI Senyu;DING Ming(Department of Respiratory and Critical Care,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu,212000,China)

机构地区：[1]江苏大学附属医院呼吸与危重症医学科,江苏镇江212000

出　　处：《当代医学》2023年第6期76-80,共5页Contemporary Medicine

基　　金：镇江市重点研发计划(社会发展)(SSH20200140100)。

摘　　要：目的探讨降钙素原(PCT)、中性粒细胞与淋巴细胞计数比值(NLR)及联合检测诊断脓胸的价值。方法回顾性选取2014年1月至2020年10月本院临床诊断为自发性脓胸的40例患者作为病例组,另选取同期本院收治的40例漏出性胸腔积液患者作为对照组,两组均检测血清PCT水平、中性粒细胞计数、淋巴细胞计数,计算NLR。比较两组PCT水平、NLR,采用Logistic回归模型构建PCT和NLR的联合预测因子,绘制ROC曲线,比较PCT、NLR单独检测及联合检测对脓胸的诊断价值。结果病例组PCT水平、NLR均高于对照组,差异有统计学意义(P<0.05)。PCT和NLR诊断脓胸的最佳诊断临界值分别为>0.22μg/L、>6.32;灵敏度分别为95.00%、90.00%,特异度分别为90.00%、85.00%,AUC分别为0.958、0.927;联合检测诊断脓胸的灵敏度、特异度最高,分别为97.50%、92.50%;联合检测和PCT、NLR单独检测诊断脓胸的AUC均>0.9,具有较高的诊断效能;联合检测诊断脓胸的AUC大于NLR单独检测(P<0.05),联合检测与PCT单独检测的AUC比较差异无统计学意义,PCT与NLR单独检测的AUC比较差异无统计学意义。结论PCT、NLR单独检测对脓胸均有较高的诊断价值,但二者联合检测可进一步提高诊断灵敏度、特异度及预测价值。Objective To investigate the value of procalcitonin(PCT)and neutrophil-lymphocyte ratio(NLR)and combined detection in the diagnostic of pyothorax.Methods A total of 40 patients with spontaneous pyothorax diagnosed in our hospital from January 2014 to October 2020 were retrospectively selected as the case group,and 40 patients with leakage pleural effusion admitted to our hospital during the same period were selected as the control group,serum PCT level,neutrophil count and lymphocyte count were detected in the two groups,and NLR was calculated.The levels of PCT level and NLR were compared between the two groups,the Logistic regression model was used to construct the combined predictor of PCT and NLR,ROC curve was drawn to compare the diagnostic value of PCT,NLR alone and combined detection for pyothorax.Results The level of PCT and NLR in case group were higher than those in control group,and the difference was statistically significant(P<0.05).The optimal critical values of PCT and NLR were>0.22μg/L and>6.32,respectively;the sensitivity were 95.00%and 90.00%,the specificity were 90.00%and 85.00%,and the AUC were 0.958 and 0.927,respectively;the sensitivity and specificity of combined detection in the diagnosis of pyothorax were 97.50%and 92.50%,respectively;the AUC of combined detection,PCT and NLR alone detection in the diagnosis of pyothorax was>0.9,which had high diagnostic efficacy.The AUC of combined detection in the diagnosis of pyothorax was higher than that of NLR alone(P<0.05),but there was no significant difference between the AUC of combined detection and PCT alone,and there was no significant difference between PCT and NLR alone.Conclusion PCT,NLR have high diagnostic value in the pyothorax,but combined detection can further improve the sensitivity and specificity in the diagnosis of pyothorax.

关 键 词：降钙素原 中性粒细胞与淋巴细胞计数比值 脓胸 诊断价值 

分 类 号：R441[医药卫生—诊断学]