NLR和PCT对成人社区获得性肺炎患者进展为脓毒症的预测价值比较

目的分析中性粒细胞与淋巴细胞比值(NLR)和降钙素原(PCT)对成人社区获得性肺炎(CAP)患者进展为脓毒症的预测价值。方法收集2015年1月-2018年12月中国医科大学附属盛京医院呼吸内科收治的成人CAP患者409例临床资料,根据是否进展为脓毒症,将其分为脓毒症组201例,非脓毒症组208例,检测各组NLR和PCT水平,采用受试者工作特征曲线(ROC)比较NLR和PCT对成人CAP患者进展为脓毒症的预测价值。结果脓毒症组NLR和PCT水平均高于非脓毒症组(U=4 136.000、2 757.000,P均=0.000);ROC曲线分析显示,NLR和PCT预测脓毒症的曲线下面积分别为0.90、0.93,最佳截断值为7.25、0.22 ng/ml,敏感度为82.1%、87.1%,特异度为86.1%、88.9%,阳性预测值为85.5%、88.7%性预测值为82.8%、87.3%,约登指数为0.68、0.76。结论 NLR和PCT对成人CAP患者进展为脓毒症有一定的预测价值,其中PCT价值更高。

Comparison of the predictive value of NLR and PCT in the development of sepsis in adult patients with community-acquired pneumonia

Objective To analyze and compare the predictive value of the neutrophil-lymphocyte ratio(NLR) and procalcitonin(PCT) in the development of sepsis in adult patients with community-acquired pneumonia(CAP).Methods Four hundred and nine adult patients with CAP hospitalized in the Department of Respiratory Medicine,Shengjing Hospital Affiliated to China Medical University from January 2015 to December 2018 were collected.According to whether it developed into sepsis or not,it was divided into sepsis group 201 cases and non-sepsis group 208 cases.The levels of NLR and PCT in each group were observed.The predictive value of NLR and PCT in the development of sepsis in adult patients with CAP was compared by using ROC curve.Results The levels of NLR and PCT in the sepsis group were higher than those in the nonsepsis group(U=4 136.000,U=2 757.000,P=0.000).ROC curve comparison:The area under NLR and PCT curves was 0.93 and 0.90,the best cutoff value was 7.25 and 0.22 ng/ml,the sensitivity was 82.1% and 87.1%,the specificity was 86.1% and 88.9%,the positive predictive value was 85.5% and 88.7%,the negative predictive value was 82.8% and87.3%,and the Youden index was 0.68 and 0.76.Conclusion The NLR and PCT have certain predictive value in the development of sepsis in adult patients with CAP,and PCT has better value.