摘要
目的探究中性粒细胞/淋巴细胞比值(NLR)、D⁃二聚体(D⁃D)、单核细胞/淋巴细胞比值(MLR)评估重症肺炎(SP)患者病情严重程度及预后中的价值。方法选择2020年5月至2022年6月首都医科大学附属北京世纪坛医院诊治的130例急诊SP患者,根据病情严重程度将患者分为低危组(PSI<90分,n=17)、中危组(PSI:90~130分,n=48)、高危组(PSI:>130分,n=65),根据CURB⁃65评分将患者分成1组(危险因素≤1项,n=10)、2组(2项危险因素,n=53)、3组(危险因素≥3项,n=67),再依照患者预后分成预后良好组、预后不良组,对比不同病情严重程度、不同CURB⁃65评分、不同预后情况患者的NLR、D⁃D、MLR水平,并采用Logistic分析影响患者预后的相关因素。结果不同病情严重程度SP患者的NLR、MLR呈现:低危组<高危组<中危组,D⁃D水平呈现:低危组<中危组<高危组,差异均有统计学意义(P<0.05);不同CURB⁃65评分SP患者的NLR、MLR呈现:1组<3组<2组,D⁃D水平呈现:1组<2组<3组,差异均有统计学意义(P<0.05);不同预后的SP患者在年龄、吸烟史、基础病及人血白蛋白水平等方面比较差异无统计学意义(P>0.05),预后良好组NLR、D⁃D、MLR、IL⁃6、CRP、PCT水平显著低于预后不良组,差异均有统计学意义(P<0.05);经Logistic分析得出,NLR、D⁃D、MLR水平是影响SP患者预后不良的因素。结论NLR、D⁃D、MLR能有效评估SP患者病情严重程度,并预测其预后情况,可为治疗提供指导。
Objective To explore the value of neutrophil/lymphocyte ratio(NLR),D⁃dimer(D⁃D)and monocyte/lymphocyte ratio(MLR)in evaluating the severity and prognosis of severe pneumonia(SP)patients.Methods 130 emergency SP patients diagnosed and treated in Beijing Shijtan Hospital affiliated to Capital Medical University from May 2020 and June 2022 were selected,and according to the severity of the disease,the patients were divided into the low⁃risk group(PSI<90 points,n=17),the intermediate⁃risk group(PSI:90~130 points,n=48),the high⁃risk group(PSI:>130 points,n=65),according to the CURB⁃65 score,the patients were divided into group 1(risk factor≤1 item,n=10),group 2(2 items risk factors,n=53),group 3(risk factors≥3 items,n=67),and then were divided into the good prognosis group and the poor prognosis group according to the prognosis of patients,and the NLR,D⁃D and MLR levels of patients with different disease severity,different CURB⁃65 scores and different prognosis were compared,and the factors affecting prognosis were analyzed by Logistic.Results The NLR and MLR of SP patients with different disease severity showed:low risk group<high risk group<medium risk group,and the D⁃D level showed:low risk group<medium risk group<high risk group,the differences were statistically significant(P<0.05).The NLR and MLR of SP patients with different CURB⁃65 scores showed:group 1<group 3<group 2,and D⁃D level showed:group 1<group 2<group 3,the differences were statistically significant(P<0.05).There was no significant difference in age,smoking history,underlying disease and human serum albumin level among SP patients with different prognosis(P>0.05),and NLR,D⁃D,MLR,IL⁃6,CRP and PCT levels in the good prognosis group were significantly lower than those in the poor prognosis group,the differences were statistically significant(P<0.05).Logistic analysis showed that NLR,D⁃D and MLR levels were the risk factors affecting the poor prognosis of SP patients.Conclusion NLR,D⁃D and MLR can effectively evaluate the severity of emergency SP patients,predict their prognosis,and provide guidance for clinical treatment.
作者
杨丽莎
王艳平
李淑娇
隗合禹
YANG Lisha;WANG Yanping;LI Shujiao;WEI Heyu(Department of Emergency Clinic,Beijing Shijitan Hospital,Capital Medical University,Beijing,China,100038;Department of Medical Laboratory,Beijing Shijitan Hospital,Capital Medical University,Beijing,China,100038)
出处
《分子诊断与治疗杂志》
2023年第7期1203-1206,1211,共5页
Journal of Molecular Diagnostics and Therapy
基金
北京市自然科学基金面上项目(71852193)。
