中性粒细胞计数、单核细胞计数、中性粒细胞与单核细胞比值与间质性肺疾病急性加重短期转归的相关性分析  

Correlation analysis of neutrophil count,monocyte count and NMR with short-term outcome of acute exacerbation of interstitial lung disease

作　　者：单楚笑 孙宜田 朱孟静 瞿海燕 嵇璇 陈碧 SHAN Chuxiao;SUN Yitian;ZHU Mengjing;QU Haiyan;JI Xuan;CHEN Bi(Department of Respiratory and Critical Illness,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院呼吸与危重症学科,江苏徐州221000

出　　处：《安徽医药》2024年第10期2043-2049,共7页Anhui Medical and Pharmaceutical Journal

基　　金：江苏省“六大人才高峰”高层次人才项目(WSN-081)。

摘　　要：目的探讨中性粒细胞(NEU)计数、单核细胞(MON)计数及中性粒细胞与单核细胞比值(NMR)在间质性肺疾病急性加重(AE-ILD)短期转归方面的诊断价值。方法回顾性分析2020年1月至2022年1月在徐州医科大学附属医院住院的间质性肺疾病(ILD)病人137例的临床资料,并进行电话随访,选取健康体检者100例作为健康对照组,检测比较急性加重(AE)组50例和稳定期组87例的基本资料和血清NEU、MON及NMR水平变化,评估其在AE-ILD 28 d内死亡风险评估中的临床价值。结果ILD病人血清NEU、MON水平显著高于健康对照组,AE组病人的NEU[6.68(4.74,9.25)×10^(9)/L]和NMR[14.37(9.71,32.14)]水平明显高于稳定期组[4.10(3.24,5.82)×10^(9)/L、9.92(7.45,12.26)](P<0.05)。在AE死亡病人组中,血清NEU、NMR水平显著升高,MON水平显著下降。当NEU>6.86×10^(9)/L,预测AE-ILD病人28 d内死亡风险的灵敏度为73.7%,特异度为77.4%,曲线下面积(AUC)为0.73;MON<0.32×10^(9)/L,灵敏度为84.2%,特异度为93.5%,AUC为0.89;NMR>16.54,灵敏度为95.8%,特异度为87.1%,AUC是0.98。NMR对AE-ILD病人的28 d内死亡风险预测价值明显高于NEU与MON,以上均差异有统计学意义(P<0.05)。结论当ILD病人发生AE时,病人的NEU和NMR水平升高;NEU、NMR升高和MON降低可以作为预测AE-ILD病人28 d内死亡风险的血清学标志物,且NMR对早期预后的预测能力更高。Objective To investigate the diagnostic value of neutrophil count(NEU),monocyte count(MON)and neutrophil-to-monocyte ratio(NMR)with the early prognosis of acute exacerbation of interstitial lung disease(AE-ILD).Methods Patients with clinically confirmed interstitial lung disease(ILD)admitted to the Affiliated Hospital of Xuzhou Medical University between January 2020 and January 2022 were analyzed by a retrospective exploratory approach,and telephone follow-up was conducted.Select 100 healthy examinees as the healthy control group.Compare the basic data and serum NEU,MON,and NMR levels of 50 cases in the acute exacerbation(AE)group and 87 cases in the stable phase group,and evaluate their clinical value in assessing the risk of death within 28 days of AE-ILD.Results Serum NEU and MON levels were significantly higher in patients with ILD than those in healthy controls,and NEU and NMR levels were significantly higher in patients in the AE group[6.68(4.74,9.25)×10^(9)/L,14.37(9.71,32.14)]than those in the stable group[4.10(3.24,5.82)×10^(9)/L,9.92(7.45,12.26)](P<0.05).In the group of patients who died,serum NEU and NMR levels were significantly higher and MON levels were significantly lower.When NEU>6.86×10^(9)/L,the sensitivity of predicting the risk of death within 28 days in AE-ILD patients is 73.7%,the specificity was 77.4%and the area under the curve(AUC)was 0.726;MON<0.32×10^(9)/L,the sensitivity was 84.2%,the specificity was 93.5%and the AUC was 0.89;NMR>16.54.The sensitivity was 95.8%,specificity was 87.1%and AUC was 0.98.The predictive value of NMR for the risk of death within 28 days of AE-ILD is significantly higher than that of NEU and MON.The differences in the above indicators were statistically significant(P<0.05).Conclusion NEU and NMR levels increased in ILD patients with AE.Increased NEU,NMR and decreased MON can be used as serological markers to predict the risk of death within 28 days in AE-ILD patients,and NMR has a higher predictive power for early prognosis.

关 键 词：肺疾病 间质性 医院死亡率 中性粒细胞 单核细胞 预后 

分 类 号：R563[医药卫生—呼吸系统]