中性粒细胞与淋巴细胞计数比值联合降钙素原在肺结核和社区获得性细菌性肺炎鉴别诊断中的应用价值

Applied Value of NLR Joint Procalcitonin in Differential Diagnosis of Tuberculosis and Community Acquired Bacterial Pneumonia

目的探讨NLR联合PCT在肺结核和社区获得性细菌性肺炎鉴别诊断中的应用价值。方法选取我院2014年1月至2016年5月收治的疑似肺结核患者192例和社区获得性细菌性肺炎患者205例,将NLR计算出来,应用ELFA技术检测血清PCT,对两组患者的实验室检查结果、各实验室检查指标在肺结核和社区获得性细菌性肺炎鉴别诊断中的效能进行统计分析。结果肺结核组患者的淋巴细胞计数显著多于社区获得性细菌性肺炎组,差异有统计学意义(P<0.05),白细胞计数、中性粒细胞计数均显著少于社区获得性细菌性肺炎组,差异有统计学意义(P<0.05),NLR、PCT均显著低于社区获得性细菌性肺炎组(P<0.05),NLR+PCT在肺结核和社区获得性细菌性肺炎鉴别诊断中的ROC曲线下面积显著大于白细胞计数、中性粒细胞计数、淋巴细胞计数、NLR、PCT,差异有统计学意义(P<0.05),最佳临界值<6.0时敏感性、特异性、阳性预测值、阴性预测值分别达到了87.0%、65.1%、76.4%、89.0%,基本能够将肺结核排除掉。结论 NLR联合PCT在肺结核和社区获得性细菌性肺炎鉴别诊断中具有较高的应用价值。

Objective The applied value of NLR joint PCT in differential diagnosis of tuberculosis and community ac- quired bacterial pneumonia was discussed. Methods 192 cases of patients with suspected tuberculosis and 205 cases of patients with community acquired bacterial pneumonia were selected from January 2014 to May 2016 in our hospital,whose NLR was colcu- lated and the serum PCT was detected by ELFA technology. The laboratory examination results of two groups of patients and the ef- ficacy of each laboratory examination index in the differential diagnosis of tuberculosis and community acquired bacterial pneumonia were statistically analyzed. Results The lymphocyte count of tuberculosis group was significantly more than the community ac- quired bacteria] pneumonia group （ P 〈 0. 05 ） , while the white blood cell count, neutrophil count were significantly less than the community acquired bacterial pneumonia group（ P 〈 0. 05 ）and the NLR, PCT were significantly lower than that of community ac- quired bacterial pneumonia group（ P 〈 0. 05 ）. The area of NLR ＋ PCT in the differential diagnosis o~ tuberculosis and community acquired bacterial pneumonia under the ROC curve was significantly greater than the WBC count, neutrophil count, lymphocyte count,NLR and PCT （P 〈 0. 05 ）. The sensitivity, specificity, positive predictive value, negative predictive value was 87.0%, 87.0% ,76. 4% and 89. 0% respectively when the best threshold lower than 6.0, so NLR ＋ PCT can basically exclude pulmonary tuberculosis. Conclusion NLR joint PCT has high applied value in differential diagnosis of tuberculosis and community acquired bacterial pneumonia.