LCR联合FAR对老年胃癌患者术后肺炎的诊断价值  

Value of LCR combined with FAR in diagnosis of postoperative pneumonia in elderly patients with gastric cancer

作　　者：林志浩 田园 何磊[1] LIN Zhihao;TIAN Yuan;HE Lei(Department of Gastrointestinal Surgery,Hefei First People’s Hospital,Hefei 230001,Anhui,China)

机构地区：[1]合肥市第一人民医院胃肠外科,安徽合肥230001

出　　处：《中国现代医生》2025年第10期29-33,共5页China Modern Doctor

摘　　要：目的探讨淋巴细胞与C反应蛋白比值(lymphocyte to C-reactive protein ratio,LCR)联合纤维蛋白原与白蛋白比值(fibrinogen to albumin ratio,FAR)对老年胃癌患者术后肺炎的诊断价值。方法选取2017年9月至2024年3月于合肥市第一人民医院行胃癌根治术的老年患者134例为研究对象,根据术后是否发生肺炎,将患者分为无并发症组(n=109)和并发症组(n=25)。比较两组患者的一般资料和实验室检查结果。采用多因素Logistic回归模型探究胃癌患者术后肺炎的影响因素,绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)计算不同指标及其联合应用的曲线下面积(area under the curve,AUC),预测其在术后肺炎方面的价值。结果并发症组患者的体质量指数、淋巴细胞、白蛋白、LCR均显著低于无并发症组,白细胞、纤维蛋白原、C反应蛋白、FAR、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值均显著高于无并发症组(P<0.05)。多因素Logistic回归分析结果显示术前LCR降低和FAR升高均是胃癌患者术后肺炎的独立危险因素(P<0.05)。ROC曲线分析结果显示,LCR和FAR诊断胃癌患者术后肺炎的AUC分别为0.727和0.719,二者联合诊断的AUC为0.790(95%CI:0.702~0.879)。结论术前LCR和FAR均是胃癌患者术后肺炎的独立危险因素,二者联合可有效预测胃癌患者术后肺炎并发症,从而指导临床决策。Objective To explore the diagnostic value of lymphocyte to C-reactive protein ratio(LCR)combined with fibrinogen to albumin ratio(FAR)for postoperative pneumonia in elderly patients with gastric cancer.Methods A total of 134 elderly patients who underwent radical gastrectomy in Hefei First People’s Hospital from September 2017 to March 2024 were selected as study objects.According to whether pneumonia occurred after surgery,patients were divided into uncomplication group(n=109)and complication group(n=25).General data and laboratory results were compared between two groups.Multivariate Logistic regression model was used to explore the influencing factors of postoperative pneumonia in patients with gastric cancer.The receiver operating characteristic(ROC)curve was plotted to calculate the area under the curve(AUC)of different indicators and their combined application in order to predict their value in postoperative pneumonia.Results The body mass index,lymphocyte,albumin and LCR in complication group were significantly lower than those in uncomplication group,while white blood cell,fibrinogen,C-reactive protein,FAR,neutrophil to lymphocyte ratio and platelet to lymphocyte ratio were significantly higher than those in uncomplication group(P<0.05).Multivariate Logistic regression analysis showed that preoperative LCR reduction and FAR increase were independent risk factors for postoperative pneumonia in gastric cancer patients(P<0.05).ROC curve analysis results showed that the AUC of postoperative pneumonia in patients with gastric cancer diagnosed by LCR and FAR was 0.727 and 0.719,respectively,and the AUC of combined diagnosis was 0.790(95%CI:0.702-0.879).Conclusion Preoperative LCR and FAR are independent risk factors for postoperative pneumonia in patients with gastric cancer,and their combination can effectively predict postoperative pneumonia complications in patients with gastric cancer,so as to guide clinical decision-making.

关 键 词：淋巴细胞 C反应蛋白 纤维蛋白原 白蛋白 胃癌 术后肺炎 

分 类 号：R619.3[医药卫生—外科学]