血乳酸水平联合中性粒细胞/淋巴细胞比值对重症肺炎预后风险预测

Prognostic risk prediction of severe pneumonia by blood lactate level combined with neutrophil/lymphocyte ratio

目的研究血乳酸(LAC)水平联合中性粒细胞与淋巴细胞比值(NLR)在ICU重症肺炎预后风险预测中的应用价值。方法采用分层整群抽样法进行抽样调查,抽取2020年1月-2022年1月期间南华大学附属长沙中心医院收治的88例重症肺炎患者并将其设为研究对象,依据患者预后情况(死亡/治愈)进行分组,对照组(30例,死亡),实验组(58例,治愈),对所有研究对象临床资料及LAC、NLR检查结果进行收集,对比两组数据差异情况,对其中有差异项采用Logistic回归方程进行计算,分析LAC、NLR是否可作为ICU重症肺炎预后风险预测指标并进行对比。结果实验组、对照组患者在性别(男/女)、年龄(≥70岁/<70岁)、ICU住院时间(≥15d/<15d)、是否合并基础病、是否实施机械通气、BMI(≥21.5kg/m2/<21.5kg/m2)方面对比无明显差异(P>0.05),在LAC(≥5.08mmol/L/<5.08mmol/L)、NLR(≥8.75/<8.75)方面差异显著(P<0.05);将上述有差异因素带入Logistic回归方程计算发现,LAC(≥5.08mmol/L/<5.08mmol/L)、NLR(≥8.75/<8.75)均是ICU重症肺炎患者预后影响因素;LAC与NLR联合预测准确度(98.86%)、特异度(100.00%)、敏感度(97.73%)均明显高于LAC单项检测(67.05%、70.45%、71.59%)、NLR单项检测(68.18%、69.32%、72.73%)(P<0.05)。结论LAC联合NLR在ICU重症肺炎预后风险预测中具有极高的应用价值,通过检查可适时调整治疗措施,降低重症肺炎病死率,建议临床在诊疗过程中选用。

Objective To study the application value of blood lactic acid(LAC)level combined with neutrophil to lymphocyte ratio(NLR)in prognosis risk prediction of severe pneumonia in ICU.Methods The stratified cluster sampling method was used for sampling investigation.88 patients with severe pneumonia in our hospital from January 2020 to January 2022 were selected and set as the study.The patients were divided into two groups according to their prognosis(death/cure):the control group(30 cases,death)and the experimental group(58 cases,cure).The clinical data of all the subjects and the results of LAC and NLR examinations were collected,and the data differences between the two groups were compared,Logistic regression equation was used to calculate the difference items and analyze whether LAC and NLR could be used as prognostic risk indicators of severe pneumonia in ICU;another comparison.Results There was no significant difference between the experimental group and the control group in terms of gender(male/female),age(≥70/<70years old),length of stay in ICU(≥15/<15days),whether basic disease was complicated,whether mechanical ventilation was implemented,and BMI(≥21.5 kg/m2/<21.5kg/m2)(P>0.05).There was significant difference in terms of LAC(≥5.08mmol/L/<5.08mmol/L)and NLR(≥8.75/<8.75)(P<0.05);the above differential factors were brought into the Logistic regression equation,and it was found that LAC(≥5.08mmol/L/<5.08mmol/L)and NLR(≥8.75/<8.75)were the prognostic factors of ICU patients with severe pneumonia;the accuracy(98.86%),specificity(100.00%)and sensitivity(97.73%)of the combined prediction of LAC and NLR were significantly higher than those of LAC(67.05%,70.45%,71.59%)and NLR(68.18%,69.32%,72.73%)(P<0.05).Conclusion LAC combined with NLR is of great value in predicting the prognosis risk of severe pneumonia in ICU.Through examination,the treatment measures can be adjusted timely to reduce the mortality of severe pneumonia.It is recommended to use it in clinical diagnosis and treatment.