淋巴细胞计数联合降钙素原在脓毒症早期筛查中的效能研究

Efficacy of lymphocyte count combined with procalcitonin in the early screening of sepsis

目的评价淋巴细胞计数(Lym)联合降钙素原(PCT)在脓毒症早期筛查中的效能。方法纳入2019年9月至2021年4月重庆医科大学附属第一医院疑似感染的患者268例作为研究对象,其中脓毒症患者143例,非脓毒症患者125例。收集临床资料,并对临床常见指标进行单因素及多因素logistic回归分析,采用受试者工作特征曲线(ROC曲线)比较不同指标的筛查效能。结果单因素logistic回归分析显示,Lym、中性粒细胞绝对值(N#)、白细胞计数(WBC)、中性粒细胞/淋巴细胞比值(NLR)、血小板计数(PLT)、PCT、乳酸(Lac)、快速序贯器官功能衰竭评估(qSOFA)在2组中差异均有统计学意义(P<0.05)。多因素logistic回归分析显示Lym、PCT、WBC、qSOFA是脓毒症患病的独立危险因素(P<0.05)。ROC曲线表明,Lym联合PCT的ROC曲线下面积(AUC)最高,AUC为0.940(95%置信区间为0.904~0.965)。结论脓毒症患者早期具有Lym降低、PCT水平升高的特点,采用Lym联合PCT对脓毒症早期具有较高的筛查效能。

Objective To evaluate the efficacy of lymphocyte(Lym)count combined with procalcitonin(PCT)in the early screening of sepsis.Methods Patients with suspected infection from September 2019 to April 2021 at the First Affiliated Hospital of Chongqing Medical University were included.A total of 268 patients with 143 sepsis and 125 non-sepsis were included in this study.Related clinical biomarkers were statistically analyzed using univariate and multivariate logistic regression.A comparative analysis of the screening efficacy of different biomarkers was made using the receiver operator characteristic(ROC)curve.Results Univariate logistic regression analysis showed that Lym,neutrophil count(N#),leukocytes(WBC),neutrophil-lymphocyte ratio(NLR),platelets(PLT),PCT,lactate(Lac),and quick Sequential Organ Failure Assessment(qSOFA)were significantly different in the two groups(P<0.05).Multivariate logistic regression analysis showed that Lym,PCT,WBC,and qSOFA were independent risk factors for the development of sepsis(P<0.05).The ROC curve showed that Lym combined with PCT had the largest area under the ROC curve(AUC),AUC was 0.940(95%CI 0.904-0.965).Conclusion Patients with early stage of sepsis are characterized by decreased Lym and increased PCT levels,and Lym combined with PCT has a high screening efficacy for early stage of sepsis.