外周血NLR、sTREM-1、PCT水平对老年卒中患者相关性肺炎的诊断价值

Diagnostic Values of Peripheral Blood NLR,sTREM-1 and PCT Levels in Elderly Patients with Stroke-associated Pneumonia

目的探讨血清中性粒细胞与淋巴细胞比值(NLR)、可溶性髓系细胞触发受体-1(sTREM-1)、降钙素原(PCT)对老年卒中相关性肺炎(SAP)的诊断价值。方法选取2017年12月—2019年6月收治的脑出血165例,根据其是否发生相关性肺炎,分为SAP组86例和非SAP组79例。记录2组一般情况与临床资料,分别于入院第1、3、7天检测血清PCT、sTREM-1水平及NLR值,并分析其对SAP的诊断价值。结果SAP组PCT、sTREM-1、NLR在入院第3天达到峰值,第7天逐渐下降,均高于入院第1天,入院第7天低于入院第3天(P<0.05)。SAP组入院第1、3、7天血清PCT、sTREM-1、NLR水平均高于非SAP组(P<0.01)。入院第3天,血清PCT、sTREM-1、NLR对SAP诊断价值最大,曲线下面积分别为0.920、0.922、0.894。结论血清PCT、sTREM-1、NLR可能成为SAP早期临床诊断的可靠生物学标记物,入院第3天时均达到峰值,因此上述指标在入院第3天对SAP的诊断价值最大。

Objective To investigate the diagnostic values of serum neutrophil to lymphocyte ratio(NLR),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and procalcitonin(PCT)in elderly patients with stroke-associated pneumonia(SAP).Methods A total of 165 cases of cerebral hemorrhage during December 2017 and June 2019 were selected and divided into SAP group(n=86)and non-SAP group(n=79)according to presence or absence of SAP.The levels of serum PCT,sTREM-1 and NLR were measured at 1,3 and 7 days after admission,and their diagnostic value for SAP was analyzed.Results In SAP group,PCT,sTREM-1 and NLR were peaked at 3 days after admission,and decreased gradually at 7 days,which were higher than those on the first day of admission.The indicators at 7 days were lower than those at 3 days after admission(P<0.05).At 1,3 and 7 days after admission,the levels of serum PCT,sTREM-1 and NLR were higher in SAP group than in non-SAP group,and at 3 days after admission,the areas under the ROC curve of serum PCT,sTREM-1,and NLR for diagnosis of SAP were 0.920,0.922 and 0.894,respectively.Conclusion Serum PCT,sTREM-1 and NLR may be reliable biomarkers for early clinical diagnosis of SAP,which all reached the peak value at 3 days after admission.Therefore,the above indexes are the most valuable for the diagnosis of SAP at 3 days after admission.