天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (10): 1054-1057.doi: 10.11958/20190925

• 临床研究 • 上一篇    下一篇

NLR联合降钙素原对COPD急性加重期细菌 感染患者预后价值探讨

罗德云，陈菊屏△   

  1. 西南医科大学附属医院呼吸与危重症医学二科（邮编646000）
  • 收稿日期:2019-03-26 修回日期:2019-08-16 出版日期:2019-10-15 发布日期:2019-11-11
  • 通讯作者: 陈菊屏 E-mail:jininche1996@sina.com
  • 基金资助:
     

The prognostic value of NLR combined with procalcitonin in patients with bacterial infection of acute exacerbation of COPD

LUO De-yun, CHEN Ju-ping△   

  1. The Second Department of Respiratory and Critical Care Medicinee，the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
  • Received:2019-03-26 Revised:2019-08-16 Published:2019-10-15 Online:2019-11-11
  • Supported by:
     

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摘要： 摘要：目的 探讨中性粒细胞与淋巴细胞比值（NLR）联合降钙素原（PCT）对慢性阻塞性肺疾病（COPD）急性加 重期细菌感染住院患者死亡的预测价值。方法 分析210例COPD急性加重期且痰培养至少2次发现细菌感染的患 者，根据出院时的存活情况分为存活组 188 例，病死组 22 例。比较 2 组患者的临床资料、实验室检查结果，通过 Logistic回归模型分析患者死亡的危险因素，受试者工作特征（ROC）曲线分析NLR、PCT及NLR联合PCT对COPD急 性加重期细菌感染患者死亡的预测价值。结果 病死组的白细胞计数（WBC）、中性粒细胞计数（NEU）、NLR、PCT、C 反应蛋白（CRP）、动脉血二氧化碳分压［p（CO2）］高于存活组，而pH值、白蛋白低于存活组（均P＜0.05）。Logistic回 归分析显示，NLR（OR=1.329，95%CI：1.106～1.597）和PCT（OR=1.306，95%CI：1.012～1.685）升高是患者死亡的高危因素。ROC 曲线显示，NLR、PCT 和 NLR 联合 PCT 预测回归模型的曲线下面积（AUC）均大于 0.7，特异度分别为 0.739、0.564、0.702，敏感度分别为0.727、0.909、0.909。结论 NLR和PCT对COPD急性加重期细菌感染住院患者死 亡具有良好的预测价值，两者联合评估能提高预测的准确性。

关键词: 肺疾病, 慢性阻塞性, 急性病, 诊断, 鉴别, 敏感性与特异性, 中性粒细胞与淋巴细胞比值, 降钙素原

Abstract: Abstract：Objective To investigate the predictive value of neutrophil-lymphocyte ratio (NLR) combined with procalcitonin (PCT) in the death of patients with bacterial infection of acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods Data of 210 patients with bacterial infection (sputum culture found bacteria at least twice) of acute exacerbation of COPD were analyzed retrospectively. The patients were divided into survival group (n=188) and nonsurvival group (n=22) according to the survival status at the time of discharge. Clinical data and laboratory results were compared between the two groups. The risk factors for death was analyzed by Logistic regression model, and predictive values of NLR, PCT and NLR combined with PCT in the death of patients with bacterial infection of acute exacerbation of COPD were analyzed by receiver operating characteristic (ROC) curve. Results Compared with survival group, the white blood cell count (WBC), neutrophil count (NEU), NLR, PCT, C-reactive protein (CRP) and arterial blood carbon dioxide partial pressure [ p(CO2) ] were significantly higher in non-survival group, while pH value and albumin were significantly lower in non-survival group (P＜0.05). Logistic regression analysis showed that the elevated NLR (OR=1.329, 95%CI:1.106-1.597) and PCT (OR=1.306, 95% CI:1.012-1.685) were high risk factors for death in patients. The ROC curve showed that the area under the curve (AUC) of the NLR, PCT, predictive regression model of NLR combined with PCT were greater than 0.7. And their specificities were 0.739, 0.564, and 0.702, the sensitivities were 0.727, 0.909, and 0.909. Conclusion Both NLR and PCT have preferably good predictive values for death in patients with bacterial infection of acute exacerbation of COPD. The predictive value is higher when the NLR and PCT were evaluated together.

Key words: pulmonary disease, chronic obstructive, acute disease, diagnosis, differential, sensitivity and specificity, neutrophil to lymphocyte ratio, procalcitonin

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