血RDW、D-二聚体水平、NLR、PCT∕Alb检测对社区获得性肺炎患者病情的评估价值  

Evaluation value of serum RDW,D-dimer,NLR and PCT∕Alb ratio for disease severity in patients with community-acquired pneumonia

作　　者：毛金芳 何艳 张育红 Mao Jinfang;He Yan;Zhang Yuhong(Department of Respiratory Medicine,East City Hospital Affiliated to Anhui Medical University,Hefei 231600,China)

机构地区：[1]安徽医科大学第一附属医院东城院区呼吸内科,合肥231600

出　　处：《中华保健医学杂志》2025年第1期23-26,共4页Chinese Journal of Health Care and Medicine

基　　金：安徽省卫生健康科研项目(AHWJ2022b046)。

摘　　要：目的探讨血红细胞体积分布宽度(RDW)、D-二聚体水平、中性粒细胞与淋巴细胞计数比值(NLR)、降钙素原与白蛋白比值(PCT∕Alb)对社区获得性肺炎(CAP)患者病情的评估价值。方法回顾性分析2022年1月~2024年5月安徽医科大学第一附属医院收治的177例CAP患者的临床资料,根据CURB-65肺炎严重程度评分将患者分为重症组(n=58,≥3分)和非重症组(n=119,<3分)。比较两组患者的临床特征,血RDW、D-二聚体水平、NLR和PCT∕Alb对CAP患者病情的评估价值,采用多因素logistic回归模型分析影响CAP患者疾病严重程度的危险因素,采用受试者工作特征(ROC)曲线分析各指标对CAP的诊断价值。结果重症组患者的年龄大于非重症组患者,男性比例、CURB-65评分和基础疾病比例均高于非重症组患者,差异均有统计学意义(U∕χ^(2)=-3.237、7.602、-11.337、6.480,P<0.05)。多因素logistic回归分析结果显示,血RDW、D-二聚体水平、NLR和PCT∕Alb过高均是影响CAP患者疾病严重程度的独立危险因素(P<0.05)。ROC曲线分析结果显示,血RDW、D-二聚体、NLR和PCT∕Alb均对CAP患者病情具有良好的评估价值(P<0.05)。结论血RDW、D-二聚体水平、NLR和PCT∕Alb对CAP患者的病情具有较好的评估价值。Objective To measure serum red blood cell distribution width(RDW),D-dimer,the ratio of neutrophils to lymphocytes(NLR)and procalcitonin∕albumin(PCT∕Alb)ratio in patients with community-acquired pneumonia(CAP),and to analyze their evaluation value for disease severity.Methods A total of 187 patients with CAP admitted to the hospital were enrolled between January 2022 and May 2024.According to scores of pneumonia severity(CURB-65),they were divided into severe group(60 cases,≥3 points)and non-severe group(127 cases,<3 points).The general data,serum RDW,D-dimer,NLR and PCT∕Alb ratio were compared between the two groups.The independent risk factors of disease severity were analyzed by Logistic regression analysis,and their diagnostic value in CAP patients was analyzed by ROC curves.Results The age,proportion of males and underlying diseases,CURB-65 score,serum RDW,D-dimer,NLR and PCT∕Alb ratio in severe group were higher than those in non-severe group(U∕χ^(2)=-3.237,7.602,-11.337,6.480,-2.751,-6.686,-7.660,-8.441,P<0.05).The results of Logistic regression analysis showed that too high serum RDW,D-dimer,NLR and PCT∕Alb ratio were independent risk factors of disease severity in CAP patients(P<0.05).The results of ROC curves analysis showed that serum RDW(AUC=0.627),D-dimer(AUC=0.810),NLR(AUC=0.855)and PCT∕Alb ratio(AUC=0.891)were of good evaluation value for disease severity(P<0.05).Conclusion Serum RDW,D-dimer,NLR and PCT∕Alb ratio have good evaluation value for disease severity in CAP patients.

关 键 词：社区获得性肺炎 血红细胞分布宽度 D-二聚体 中性粒细胞计数∕淋巴细胞计数 降钙素原 白蛋白 

分 类 号：R563[医药卫生—呼吸系统]