NLR、hs-CRP及PCT联合检测在重症肺炎早期诊断及预后评估的价值  

The value of combined detection of NLR,hs-CRP and PCT in early diagnosis and prognosis evaluation of severe pneumonia

作　　者：陈栋 彭小媚 刘燕群 CHEN Dong;PENG Xiao-mei;LIU Yan-qun(Department of laboratory,Hezhou People's Hospital,Guangxi Hezhou,542800)

机构地区：[1]广西贺州市人民医院检验科,广西贺州542800

出　　处：《新疆维吾尔医学专科学校学报》2024年第4期1-9,共9页

基　　金：贺州市科学研究与技术开发计划项目“NLR、hs-CRP及PCT联合检测在重症肺炎早期诊断的应用研究”(贺科技202245)的阶段性研究成果。

摘　　要：目的探究NLR、hs-CRP及PCT三项联合检测在重症肺炎早期诊断的预测价值和预后评估价值。方法选取2022年4月至2023年4月于贺州市人民医院呼吸内科和ICU明确诊断为社区获得性肺炎患者200例作为实验组,实验组根据肺炎严重程度,分为重症肺炎组80例,非重症肺炎组120例;重症肺炎组根据患者28天内的生存情况分为存活组与病死组,比较各组间NLR、hs-CRP、PCT的水平。另选取同一期间来我院体检中心的80例健康人员设置为对照组。结果实验组NLR、hs-CRP、PCT水平分别为(8.61±2.95)、(40.65±20.05)mg/L、(4.61±2.45)ng/mL;明显高于对照组,差异具有统计学意义P<0.05。重症组NLR、hs-CRP、PCT水平分别为(13.61±2.35)、(55.61±23.05)mg/L、(5.91±2.95)ng/mL,均显著高于非重症肺炎组,差异具有统计学意义P<0.05;重症肺炎患者的病死组中,NLR、hs-CRP、PCT水平高于存活组,差异具有统计学意义P<0.05。三项联合检测的特异性、灵敏性、阴性预测值、阳性预测值分别为79.60%、80.50%、68.21%、88.01%,与单项检测指标相比,均有明显的提高。结论NLR、hs-CRP及PCT联合检测对重症肺炎早期诊断具有重要的预测价值,可对病情进展及预后进行准确预测,早期监测上述指标能为诊治方案判断及决策提供指导。Objective To analyze the predictive value and prognostic value of combined detection of NLR,hs-CRP and PCT in early diagnosis of severe pneumonia.Methods A total of 200 patients were selected as the observation group of pneumonia in Hezhou People's Hospital from April 2022 to April 2023.The experimental group was divided into a severe pneumonia group of 80 patients were selected as the severe pneumonia group,and 120 patients were selected as the non-serious pneumonia group.The se-vere pneumonia group was divided into survival group and death group according to the survival condition within 28 days.80 healthy people were selected as the control group in the same period from physical ex-amination center of our hospital.In addition,the levels of NLR,hs-CRP and PCT were measured and com-pared.Results The levels of NLR,hs-CRP and PCT were(8.61±2.95),(40.65±20.05)mg/L,(4.61±2.45)ng/mL,which were significantly higher than in the control group P<0.05.The levels of NLR,hs-CRP and PCT in the severe pneumonia group were(13.61±2.35),(55.61±23.05)mg/L,(5.91±2.95)ng/mL,which were significantly higher than in the non-severe pneumonia group P<0.05.Compared with the sur-vival group,in the death group,the levels of NLR,hs-CRP and PCT were significantly higher than those in the survival group P<0.05.The specificity、sensitivity、negative predictive value and positive predictive value of the combined detection with all three indexes in the diagnosis of severe pneumonia were79.60%、80.50%、68.21%and 88.01%,respectively,which were significantly higher than that of any single-index detection.Conclusion The combined detection of NLR,hs-CRP and PCT has important predictive value for early diagnosis of severe pneumonia,and can accurately predict the progression and prognosis of the disease,and the early monitoring of these indi-cators can provide guidance for judgment and decision mak-ing of diagnosis and treatment regimen.

关 键 词：重症肺炎 超敏C反应蛋白 中性粒细胞与淋巴细胞比值 降钙素原 

分 类 号：R446[医药卫生—诊断学]