NLR在社区获得性肺炎病原诊断中的应用价值

Clinical Application Value of NLR in the Etiology Diagnosis of Community-Acquired Pneumonia

目的:探讨中性粒细胞-淋巴细胞比值(NLR)在社区获得性肺炎病原诊断中的临床应用价值。方法:回顾性分析47例肺炎链球菌引起的细菌性肺炎(SP)、50例支原体肺炎(MP)和64例病毒性肺炎(VP)患者入院48 h内的血常规、降钙素原(PCT)和C反应蛋白(CRP)水平,选取NLR<5作为截断值,并对检测结果进行统计分析。结果:SP组患者白细胞(WBC)、NLR、NLR<5、PCT水平均显著高于MP组和VP组,差异均有统计学意义(P<0.05)。在区分SP与MP、SP与VP、SP与非SP时,NLR<5的诊断效能均最佳,曲线下面积分别为0.92、0.74和0.84。结论:NLR可早期区分细菌性与非细菌性感染,尤其当NLR<5时,应考虑支原体或病毒等非细菌性感染,更好地指导临床用药。

Objective:To explore the clinical application value of neutrophil-lymphocyte ratio(NLR)in the etiological diagnosis of community-acquired pneumonia.Methods:The routine blood indices,CRP and the concentration of PCT were retrospectively analyzed in 47 patients with streptococcus pneumonia(SP),50 patients with mycoplasma pneumonia(MP)and 64 patients with viral pneumonia(VP)within 48 hours after admission to hospital.NLR<5 was selected as cut-off value,and the results were analyzed by statistical methods.Results:Compared with those in MP group and VP group,the patients in SP group had higher levers of white blood cell counts,NLR,NLR<5,and PCT,the differences were statistically significant(P<0.05).NLR<5 had the best diagnostic efficacy in distinguishing between SP and MP(AUC=0.92),VP(AUC=0.74),and non-SP(AUC=0.84),respectively.Conclusion:NLR can distinguish bacterial infection from non-bacterial infection in the early stages.At the level of NLR<5,non-bacterial infection such as mycoplasma or virus should be considered,which can better guide clinical medication.