急性脑出血患者SII、RDW、GCS变化及其联合预测肺部感染的价值  

Changes of serum SII,RDW and GCS score and predictive value of combined detection for pulmonary infection in patients with acute cerebral hemorrhage

作　　者：李利霞 邬英[1] LI Lixia;WU Ying(Department of Respiratory Medicine,Bayannur Hospital,Bayannur,Inner Mongolia 015000,China)

机构地区：[1]巴彦淖尔市医院呼吸科,内蒙古巴彦淖尔015000

出　　处：《检验医学与临床》2025年第7期987-992,共6页Laboratory Medicine and Clinic

基　　金：巴彦淖尔市科技计划项目(KY202158)。

摘　　要：目的探讨急性脑出血患者全身免疫炎症指数(SII)、红细胞分布宽度(RDW)、格拉斯哥昏迷量表(GCS)评分变化及其联合预测肺部感染的价值。方法回顾性选择2021年1月至2022年12月该院收治的250例急性脑出血患者为疾病组。另选择同期该院的健康体检志愿者200例作为健康组。采集患者入院24 h及志愿者体检当日清晨空腹肘静脉血,检测常规炎症指标[C反应蛋白(CRP)、降钙素原(PCT)]及中性粒细胞计数、淋巴细胞计数、RDW水平,并计算SII,比较2组CRP、PCT、SII、RDW。根据《卒中相关性肺炎诊治中国专家共识(2019更新版)》中脑卒中相关肺炎诊断标准,将疾病组分为感染组与非感染组。使用GCS评分评估患者昏迷程度,比较感染组与非感染组的各指标水平及GCS评分。采用受试者工作特征(ROC)曲线分析CRP、PCT、SII、RDW、GCS评分及联合预测肺部感染的价值;采用多因素Logistic回归分析急性脑出血患者发生肺部感染的危险因素。结果疾病组CRP、PCT、SII、RDW水平明显高于健康组,差异均有统计学意义(P<0.05);疾病组共发生68例肺部感染,肺部感染率为27.20%;感染组与非感染组的合并高血压人数比例、使用呼吸机人数比例比较,差异均有统计学意义(P<0.05);感染组CRP、PCT、SII、RDW水平明显高于非感染组,感染组GCS评分明显低于非感染组,差异均有统计学意义(P<0.05);ROC曲线分析结果显示CRP、PCT、GCS评分、SII、RDW及其联合诊断急性脑出血患者发生肺部感染的曲线下面积(AUC)分别为0.703、0.757、0.659、0.597、0.630、0.854;多因素Logistic回归分析结果显示,合并高血压、使用呼吸机、CRP>10.22 mg/L、PCT>1.23 ng/mL、GCS评分≤7.55分、SII>942.34、RDW>14.31%是急性脑出血患者发生肺部感染的独立危险因素(P<0.05)。结论合并肺部感染的急性脑出血患者SII、RDW异常升高,GCS评分异常降低,SII、RDW、GCS评分联合常规筛查指标有�Objective To explore the changes of systemic immune-inflammation index(SII),red blood cell distribution width(RDW)and Glasgow coma scale(GCS)score,and predictive value of combined detection for pulmonary infection in patients with acute cerebral hemorrhage.Methods A total of 250 patients with acute cerebral hemorrhage admitted to the Bayannur Hospital from January 2021 to December 2022 were selected retrospectively as the disease group.Another 200 health examination volunteers from the same period in the hospital were selected as the healthy group.Collect fasting elbow vein blood from patients 24 hours after admission and volunteers on the morning of physical examination,and detect routine inflammatory indicators[C-reactive protein(CRP),procalcitonin(PCT)]and neutrophil count,lymphocyte count,RDW,calculate SII.Compare the levels of CRP,PCT,SII and RDW between the two groups.According to the diagnostic criteria for stroke related pneumonia in the"Chinese Expert Consensus on Diagnosis and Treatment of Stroke-Associated Pneumonia(2019 Updated Version)",the disease group was divided into infected group and non-infected group.Use GCS score to assess the degree of coma in patients,and compare the levels of various indicators and GCS scores between the infected group and non-infected group.Using receiver operating characteristic(ROC)curve to analyze the value of CRP,PCT,SII,RDW,GCS score,and their combined prediction for pulmonary infection.Using multivariate Logistic regression analysis to identify the risk factors for pulmonary infection in patients with acute cerebral hemorrhage.Results The levels of CRP,PCT,SII and RDW in the disease group were significantly higher than those in the healthy group,the differences were statistically significant(P<0.05).A total of 68 cases of pulmonary infection occurred in the disease group,with a pulmonary infection rate of 27.20%.The proportion of patients with combined hypertension and the proportion of patients using ventilators in the infected group and non-infected group showed

关 键 词：急性脑出血 全身免疫炎症指数 红细胞分布宽度 格拉斯哥昏迷量表 肺部感染 

分 类 号：R446.1[医药卫生—诊断学]