NLR、RDW和PCT评估老年社区获得性肺炎患者病情严重程度及预后的临床价值

Clinical Value of NLR,RDW and PCT in Evaluating the Severity of Illness and Prognosis of Elderly Patients With Community-Acquired Pneumonia

目的:探讨中性粒细胞/淋巴细胞比值(NLR)、红细胞分布宽度(RDW)及降钙素原(PCT)在老年社区获得性肺炎(CAP)患者病情严重程度及预后评估中的临床价值。方法:回顾性分析2018年1月~2020年11月期间我院收治的127例老年CAP患者的临床资料,根据英国胸科协会改良肺炎评分(CURB-65)分为低危组(CURB-65评分<3分,n=69例)和高危组(CURB-65评分≥3分,n=58例);根据患者转归分为存活组(n=114例)和死亡组(n=13例),比较各组患者的基线资料、NLR、RDW、PCT及其他实验室检查指标,并分析NLR、RDW、PCT与CURB-65评分的相关性以及预后的影响因素。结果:高危组NLR、RDW和PCT水平均显著高于低危组,差异有统计学意义(P<0.05)。经Pearson相关性分析可得:NLR、RDW、PCT与CURB-65评分均呈正相关关系(P<0.05)。生存组患者白细胞计数(WBC)、中性粒细胞(NEU)、NLR、RDW、PCT和D-二聚体(D-Dimer)水平均低于死亡组,差异具有统计学意义(P<0.05),经多因素Logistic回归分析可得:NLR、RDW、PCT均是老年CAP患者预后的影响因素(均OR>1,P<0.05)。结论:NLR、RDW和PCT与CURB-65评分相关,且均是老年CAP患者预后的影响因素,NLR、RDW和PCT对老年CAP患者病情严重程度及预后具有一定的评估价值。

Objective:To investigate the clinical value of neutrophil/lymphocyte ratio(NLR),red blood cell distribution width(RDW)and procalcitonin(PCT)in evaluating the severity of illness and prognosis of elderly patients with community-acquired pneumonia(CAP).Methods:Clinical data of 127 elderly patients with CAP who were admitted to our hospital from January 2018 to November2020 were retrospectively analyzed.According to the confusion,uremia,respiratory,BP,age 65 years(CURB-65 score),the patients were divided into low-risk group(CURB-65 score<3 scores,n=69 cases)and high-risk group(CURB-65 score≥3 scores,n=58 cases).According to their outcomes,the patients were divided into survival group(n=114 cases)and death group(n=13 cases).The clinical baseline data,NLR,RDW,PCT and other relevant laboratory examination indexes of each group were compared,and the correlation between NLR,RDW,PCT and CURB-65 were analyzed,and the evaluation value of NLR,RDW and PCT for the severity of illness and prognosis of elderly patients with CAP were evaluated.Results:The levels of NLR,RDW and PCT in high-risk group were significantly higher than those in low-risk group,with statistical significance(P<0.05).Pearson correlation analysis showed that NLR,RDW,PCT and CURB-65 were positively correlated(P<0.05).The levels of White blood cell count(WBC),Neutrophils(NEU),NLR,RDW,PCT and D-Dimer in the death group were significantly higher than those in the survival group(P<0.05).Multivariate Logistic regression analysis showed that NLR,RDW,PCT was influencing of prognosis in older patients with CAP(OR>1,P<0.05).Conclusion:NLR,RDW and PCT are correlated with CURB-65 score,which are influencing factors for the prognosis of elderly patients with CAP.NLR,RDW and PCT have certain evaluation value for the severity and prognosis of elderly patients with CAP.