SII及NLR、RDW、PLR水平与脑出血后肺部感染及预后的关系  

Correlation of levels of SII,NLR,RDW and PLR with pulmonary infection and prognosis after cerebral hemorrhage

作　　者：朱敏 黄从刚[1] 罗志华[1] 张思 ZHU Min;HUANG Cong-gang;LUO Zhi-hua;ZHANG Si(Wuhan First Hospital,Wuhan,Hubei 430022,China)

机构地区：[1]武汉市第一医院神经外科,湖北武汉430022

出　　处：《中华医院感染学杂志》2024年第16期2462-2466,共5页Chinese Journal of Nosocomiology

基　　金：湖北省卫生健康委员会联合基金项目-面上重点项目(WJ2019H331)。

摘　　要：目的 探究全身免疫炎症指数(SII)和外周血中性粒细胞计数/淋巴细胞计数比值(NLR)、红细胞分布宽度(RDW)、血小板计数/淋巴细胞计数比率(PLR)与脑出血后肺部感染的关系及对患者预后的评估价值。方法选取武汉市第一医院107例脑出血后肺部感染患者为研究对象设为感染组,另选同期80例脑出血后未发生肺部感染的患者归为非感染组,统计所有肺部感染患者的病原学特征,比较两组基线资料和SII、NLR、RDW、PLR水平,治疗后跟踪随访患者3个月,根据改良Rankin量表(mRS)评分将感染组患者分为预后良好组(n=69)和预后不良组(n=38),比较预后良好组和预后不良组SII、NLR、RDW、PLR水平,采用受试者工作特征(ROC)曲线评估SII、NLR、RDW、PLR水平对脑出血并肺部感染患者的预后预测价值。结果 107例脑出血肺部感染患者痰液标本培养出148株菌株,革兰阳性菌、革兰阴性菌、真菌占比分别为75.68%、19.59%、4.73%;多因素Logistic回归分析显示,入院NHISS评分、意识障碍、SII、NLR、RDW、PLR是影响脑出血患者肺部感染的危险因素(P<0.05);预后不良组SH、NLR、RDW、PLR值均高于预后良好组(P<0.05);ROC曲线分析显示,SII、NLR、RDW和PLR水平联合预测脑出血并肺部感染患者预后的敏感度为92.11%,特异度为60.87%,曲线下面积(AUC)为0.911,联合诊断价值更高。结论 脑出血患者SII、NLR、RDW、PLR水平是梗死后肺部感染的危险因素,且对患者预后具有较高的诊断价值。OBJECTIVE To explore the correlation of systemic immune inflammation index(SII),peripheral blood neutrophil/lymphocyte ratio(NLR),red blood cell distribution width(RDW),and platelet/lymphocyte ratio(PLR)with pulmonary infection after cerebral hemorrhage,and to evaluate the value on prognosis of patients.METHODS A total of 107 patients with pulmonary infection after cerebral hemorrhage in First Hospital of Wuhan were selected as the infection group,and 80 patients without pulmonary infection after cerebral hemorrhage were included in the non-infection group.The etiological characteristics of all patients with pulmonary infection were analyzed.The baseline data and levels of SII,NLR,RDW and PLR were compared between the two groups.The patients were followed up for 3 months after treatment and the patients in infection group were sub-divided into the good prognosis group(n=69)and poor prognosis group(n=38)according to the modified Rankin scale(mRS)score.The levels of SII,NLR,RDW and PLR were compared between the good prognosis group and poor prognosis group.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of SII,NLR,RDW and PLR levels on prognosis in patients with cerebral hemorrhage and pulmonary infection.RESULTS A total of 148 strains were cultured from sputum samples of 107 patients with cerebral hemorrhage and pulmonary infection.Gram-positive bacteria,gram-negative bacteria and fungi accounted for 75.68%,19.59%and 4.73%,respectively.Multivariate logistic regression analysis showed that NHISS score at admission,disturbance of consciousness,SII,NLR,RDW and PLR were risk factors of pulmonary infection in patients with cerebral hemor rhage(P<o.05).The SH,NLR,RDW and PLR were higher in the poor prognosis group than those in the good prognosis group(P<0.05).ROC curve analysis showed that the sensitivity of SII,NLR,RDW and PLR levels in predicting the prognosis of patients with cerebral hemorrhage and pulmonary infection was 92.11%,the specificity was 60.87%,and the area under cur

关 键 词：全身免疫炎症指数 中性粒细胞/淋巴细胞比值 红细胞分布宽度 血小板/淋巴细胞比率 脑出血 肺部感染 预后 病原菌 危险因素 

分 类 号：R563.1[医药卫生—呼吸系统]