NLR、PCT及Ca对重症肺炎预后的预测价值  

Predictive Value of NLR,PCT and Ca on the Prognosis of Severe Pneumonia

作　　者：孙阳洋 彭松[2] SUN Yangyang;PENG Song(Graduate School of Bengbu Medical University,Anhui 233030,China)

机构地区：[1]蚌埠医科大学研究生院,233030 [2]合肥市第一人民医院重症医学科,230061

出　　处：《医学研究杂志》2025年第2期177-181,共5页Journal of Medical Research

摘　　要：目的探究中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、降钙素原(procalcitonin,PCT)及血钙(calcium,Ca)对重症肺炎(severe pneumonia,SP)患者预后的预测价值。方法回顾性分析2020年1月~2023年9月合肥市第一人民医院收治的182例SP患者的临床资料,依据入院28天内预后情况将患者分为存活组(n=116)和死亡组(n=66)。采用二元Logistic回归分析SP患者发生预后不良的相关影响因素。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析NLR、PCT、Ca对SP预后的预测价值。结果死亡组患者的年龄、高血压比例、脑血管疾病比例、急性生理和慢性健康状况Ⅱ评分(acute physiology and chronic health evaluationⅡscore,APACHEⅡ)均明显高于存活组(P<0.05),D-二聚体(d-dimer,D-D)、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、NLR、PCT水平均高于存活组(P<0.05),而血小板计数(platelet,PLT)、血清白蛋白(albumin,ALB)、Ca均低于存活组(P<0.05)。NLR、PCT、ALB、NT-proBNP、Ca为SP患者死亡的独立危险因素(P<0.05)。NLR、PCT、Ca预测SP预后的曲线下面积(area under the curve,AUC)分别为0.902、0.874、0.890(P<0.05),三者联合的AUC为0.976(95%CI:0.943~0.993)。结论NLR、PCT及Ca对SP患者预后具有一定的预测价值,三者联合对SP的预测效果最佳。Objective To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR),procalcitonin(PCT)and serum calcium(Ca)on the prognosis of patients with severe pneumonia.Methods The clinical data of 182 SP patients admitted to Hefei First People′s Hospital from January 2020 to September 2023 were retrospectively analyzed.According to the prognosis within 28days of admission,they were divided into survival group(n=116)and death group(n=66).Binary Logistic regression analysis was used to analyze the related factors of poor prognosis in SP patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of NLR,PCT and Ca on the prognosis of SP.Results The age,incidence of hypertension,cerebrovascular disease and acute physiology and chronic health evaluationⅡscore(APACHEⅡ)in the death group were significantly higher than those in the survival group(P<0.05).The levels of d-dimer(D-D),N-terminal pro-brain natriuretic peptide(NT-proBNP),NLR and PCT in the death group were higher than those in the survival group(P<0.05).The platelet count(PLT),serum albumin(ALB)and Ca were lower than those in the survival group(P<0.05).NLR,PCT,ALB,NT-proBNP and Ca were independent risk factors for death in SP patients(P<0.05).The area under the curve(AUC)of NLR,PCT and Ca in predicting the prognosis of SP were 0.902,0.874 and 0.890,respectively(P<0.05),and the combined AUC of the three was 0.976(95%CI:0.943-0.993).Conclusion NLR,PCT and Ca have certain predictive value for the prognosis of SP patients,and the combination of the three has the best predictive effect on SP.

关 键 词：重症肺炎 中性粒细胞与淋巴细胞比值 降钙素原 血钙浓度 严重程度 

分 类 号：R563[医药卫生—呼吸系统]