中性粒细胞/淋巴细胞比值联合超敏C反应蛋白在社区获得性肺炎评估中的临床应用

Clinical application of neutrophil/lymphocyte ratio combined with high sensitive C reactive protein in evaluation of community acquired pneumonia

目的:探讨中性粒细胞/淋巴细胞比值(NLR)联合超敏C反应蛋白(hs-CRP)检测在社区获得性肺炎(CAP)评估中的应用价值。方法:选取我科收治的58例CAP患者为研究对象,依据PSI评分和CURB-65评分标准分为低险组和高风险组,依据预后分为好转组48例,死亡组10例。采用免疫比浊法测定hs-CRP,免疫荧光法测定降钙素原(PCT),激光散射计数法测定NLR、白细胞(WBC)计数,比较不同风险组NLR、WBC、PCT、hs-CRP的差异性,用Spearman等级相关分析法评价NLR、PCT、hsCRP、WBC之间的相关性;观察好转与死亡病例组各指标变化情况。结果:高风险组NLR、PCT、hsCRP水平高于低风险组(P<0.05),而WBC无明显差异(P>0.05),NLR与WBC之间相关性不强,与hs-CRP、PCT之间存在较强相关性;好转组WBC、PCT、NLR、hs-CRP水平明显低于死亡组(P<0.05)。结论:NLR联合hs-CRP、WBC、PCT对CAR的严重程度具有良好的评估价值,高水平NLR、hsCRP、WBC、PCT提示病情严重及预后不佳。

Objective：To explore the application value of neutrophil/lymphocyte ratio （NLR）combined with high sensi-tive C reactive protein （hs-CRP）in the evaluation of community acquired pneumonia （CAP）.Methods：From November 201 5 to October 201 6,58 cases of CAP patients admitted in our department were enrolled and divided into low risk group and high risk group according to according to the PSI score and CURB-65 standard score.According to the prognosis,48 cases were as-signed as improved group and 10 cases as death group.Hs-CRP was determined by immunoturbidimetric assay,immunofluo-rescence determination of procalcitonin （PCT）.NLR,white blood cell count were calculated by laser scattering （WBC）count. Difference in NLR,WBC,PCT,hs-CRP,Spearman＇s rank correlation were used to evaluate the correlation between groups＆nbsp;with different risks.Correlation among NLR,PCT,hs-CRP and WBC were analyzed with Spearman method.Results：the high risk group of NLR,PCT and hs-CRP were higher than that of low risk group （P 〈0.05）,while WBC had no significant differ-ence （P 〉0.05）between NLR and WBC,the correlation is not strong,there is a strong correlation between hs-CRP and PCT;WBC,PCT,NLR improved group,hs-CRP levels were significantly lower than the death group （P 〈0.05）.Conclusion：NLR combined with hs-CRP,WBC,PCT has a good assessment of the severity of CAR,high levels of NLR,hs-CRP,WBC,PCT and the severity of the disease and poor prognosis.