中性粒细胞/淋巴细胞比值对老年社区获得性肺炎患者预后的评估价值

Predictive value of neutrophil-to-lymphocyte ratio in aged patients with community acquired pneumonia

目的评价外周血中性粒细胞/淋巴细胞比值(NLR)对老年社区获得性肺炎(CAP)患者预测价值。方法回顾性分析安徽医科大学厦门174医院297例老年CAP患者,根据CURB-65评分将患者分为低风险组(n=193)和高风险组(n=104)。分别检测入院第1天血WBC、NLR和血清降钙素原(PCT)。比较两组间各变量的差异,并就NLR与CURB-65以及上述检验指标的相关性、对老年CAP住院患者死亡预测价值进行统计学分析。结果入院时NLR在高风险组为(6.39±4.23),低风险组为(2.85±1.06),两组比较差异有统计学意义(P<0.01);WBC总数在高风险组与低风险组之间差异无统计学意义(P>0.05)。NLR与CURB-65呈较强相关性。NLR预测老年人CAP死亡的受试者工作特性(ROC)曲线,曲线下面积(AUC)=0.781。结论 NLR可用于临床对老年CAP患者病情严重度的评估,对预报老年CAP死亡预后有一定意义。

Objective To investigate the predictive value of neutrophil-to-lymphocyte ratio （NLR） in the aged patients with com-munity acquired pneumonia （CAP）. Methods A retrospective cohort study was conducted. According to CURB-65 scores, total 297 elderly patients with CAP were divided into low risk group （n = 193 ） and high risk group （n = 104）. Their white blood cell （WBC） , NLR and procalcitonin （PCT） were measured on day 1 after admission. Data between the two groups were compared, and the relationship between NLR and CURB-65 score was analyzed. Results The NLR in the high risk group （6.39 ± 4.23 ） was higher than that in the low risk group （2.85 ± 1.06） （ P 〈 0.01 ）. There was no significant difference in WBC counting between the two groups （ P 〉 0.05 ）. With the predictive cut-off value of NLR （ 5. 655 ） , the AUC was 0. 781. Conclusion NLR is ot value in prediction of the severity of CAP in aged patients.