C反应蛋白、中性粒细胞及淋巴细胞比值与重症肺炎合并呼吸衰竭患者的预后关系

Prognostic value of C-reactive protein,neutrophil and lymphocyte in patients with severe pneumonia and respiratory failure

目的分析C反应蛋白(CRP)、中性粒细胞及淋巴细胞比值(NLR)与重症肺炎合并呼吸衰竭患者的预后关系。方法选取2018年1月-2020年1月医院收治的重症肺炎合并呼吸衰竭患者120例为研究对象,根据预后情况分为预后良好组(72例)与预后不良组(48例),采用流式细胞技术,利用全血细胞计数仪检测并对比预后不良组与预后良好组NLR水平,利用免疫比浊法对两组患者外周血中CRP水平进行检测。采用单因素分析影响重症肺炎合并呼吸褒竭患者预后的相关因素,以Logistic回归分析明确危险因素。采用Pearson相关性分析法分析CRP、NLR与重症肺炎合并呼吸衰竭患者预后的相关性。结果预后不良组吸烟、饮酒占比,CRP、NLR、血清降钙素原水平,机械通气史,抗菌药物使用占比高于预后良好组(P<0.05),白细胞计数、血清白蛋白、血红蛋白、平均动脉压低于预后良好组(P<0.05);Logistic回归分析显示CRP、NLR均是影响患者预后的危险因素(P<0.05);Pearson相关分析,结果显示CRP、NLR水平与重症肺炎合并呼吸衰竭患者预后呈负相关(r=-0.335,r=-0.402,P<0.05)。结论重症肺炎合并呼吸衰竭患者的CRP、NLR水平能反映患者预后情况,是导致预后不良的危险因素,对于预后预测有较好的效能。

Objective To analyze the relationship between C-reactive protein(CRP),neutrophil and lymphocyte ratio(NLR)and prognosis in patients with severe pneumonia complicated with respiratory failure.Method From January 2018 to January 2020,120 patients with severe pneumonia complicated with respiratory failure were selected as the study objects.According to the prognosis,they were divided into two groups:poor prognosis group(48cases)and good prognosis group(72cases),the levels of NLR in the patients with poor prognosis and those with good prognosis were measured by complete blood count and the levels of CRP in peripheral blood were measured by immunoturhidimetry.Univariate analysis was used to analyze the prognostic factors of severe pneumonia patients with respiratory failure.Logistic regression analysis was used to identify the risk factors.Pearson Correlation Analysis was used to analyze the correlation between CRP,NLR and the prognosis of severe pneumonia complicated with respiratory failure.Results The proportion of smoking,drinking,CRP,NLR,serum procalcitonin level,mechanical ventilation history and antibiotic use in the poor prognosis group were higher than those in the good prognosis group(P<0.05),leukocyte count,ALB,hemoglobin and mean arterial pressure were lower in patients with good prognosis(P<0.05),CRP and NLR were the risk factors for prognosis(P<0.05),Pearson correlation analysis,the results showed that CRP and NLR levels were negatively correlated with the prognosis of severe pneumonia patients with respiratory failure(r=-0.335,r=-0.402,P<0.05).Conclusion The levels of CRP and NLR in severe pneumonia patients with respiratory failure can reflect the prognosis of patients,which is a risk factor for poor prognosis.