中性粒细胞与淋巴细胞比值对老年重症社区获得性肺炎进展为脓毒症的预测价值  

Predictive value of neutrophil-to-lymphocyte ratio for progression of severe community-acquired pneumonia to sepsis in elderly patients

作　　者：席静妮 李娜 张琪 Xi Jingni;Li Na;Zhang Qi(Department of Critical Care Medicine,Xunyi County Hospital of Xianyang,Xianyang 711300,China;Department of Clinical Laboratory,Xunyi County Hospital of Xianyang,Xianyang 711300,China)

机构地区：[1]陕西省咸阳市旬邑县医院重症医学科,咸阳711300 [2]陕西省咸阳市旬邑县医院检验科,咸阳711300

出　　处：《中华老年病研究电子杂志》2024年第3期28-31,共4页Chinese Journal of Geriatrics Research(Electronic Edition)

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)对老年重症社区获得性肺炎(SCAP)进展为脓毒症的预测价值。方法选取2022年1月至2023年10月陕西省咸阳市旬邑县医院收治的老年SCAP患者78例作为研究对象,根据是否进展为脓毒症分为脓毒症组(24例)和非脓毒症组(54例)。采用t检验或χ^(2)检验对两组患者的相关资料进行单因素分析,采用多因素Logistic回归分析老年SCAP进展为脓毒症的影响因素,并采用受试者工作特征(ROC)曲线评价NLR的预测价值。结果单因素分析结果显示,脓毒症组急性生理和慢性健康状况评分Ⅱ、PCT、NLR、中性粒细胞计数、淋巴细胞计数较非脓毒症组高(P<0.05);多因素Logistic回归分析结果显示,APACHE-Ⅱ(OR=1.476,95%CI:1.051~2.071)、PCT(OR=1.975,95%CI:1.295~3.012)、NLR(OR=1.958,95%CI:1.259~3.045)为老年SCAP进展为脓毒症的危险因素(P<0.05)。ROC曲线分析结果显示,NLR预测老年SCAP进展为脓毒症的曲线下面积为0.858(95%CI:0.778~0.939),高于APACHE-Ⅱ和PCT。结论NLR可以有效预测老年SCAP进展为脓毒症的风险,且检测迅速、简便,值得临床推广。Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio(NLR)in the progression of severe community-acquired pneumonia(SCAP)to sepsis in elderly patients.Methods A total of 78 elderly patients with SCAP admitted to Xunyi County Hospital in Xianyang City from January 2022 to October 2023 were selected as the study objects.According to whether they progressed to sepsis,the subjects were divided into sepsis group(n=24)and non-sepsis group(n=54).T test or χ^(2) test were used for univariate analysis of the relevant data of the two groups.Multivariate Logistic regression was used to analyze the factors influencing the progression of SCAP to sepsis in elderly patients,and receiver operating characteristics(ROC)curve was used to evaluate the predictive value of NLR.Results The results of univariate analysis showed that the acute physiology and chroni health evaluation(APACHE)Ⅱscore,procalcitonin(PCT),NLR,neutrophil count and lymphocyte count were higher in the sepsis group than those in the non-sepsis group(P<0.05).Multivariate Logistic regression analysis showed that APACHE-Ⅱscore(OR=1.476,95%CI:1.051-2.071),PCT(OR=1.975,95%CI:1.295-3.012),NLR(OR=1.958,95%CI:1.259-3.045)were risk factors for the progression of SCAP to sepsis in the elderly(P<0.05).ROC curve analysis showed that the area under the curve of NLR for predicting SCAP progression to sepsis in the elderly was 0.858(95%CI:0.778-0.939),which was higher than those of APACHE-Ⅱscore and PCT.Conclusion The NLR can effectively predict the risk of SCAP progression to sepsis in the elderly,and the detection is rapid and simple,which is worthy of clinical promotion.

关 键 词：重症社区获得性肺炎 脓毒症 老年人 中性粒细胞与淋巴细胞比值 风险预测 

分 类 号：R563.1[医药卫生—呼吸系统]