老年肺炎患者血清LDH、PCT和NLR及其与疾病程度及预后的关系

Serum LDH,PCT and NLR in elderly patients with pneumonia and thei relationship with disease severity and prognosis

目的老年肺炎患者血清乳酸脱氢酶(LDH)、降钙素原(PCT)、中性粒细胞/淋巴细胞比值(NLR)及其与疾病程度和预后的关系.方法选取衡水市人民医院2019年1月-2022年9月收治的205例老年肺炎患者,分为重症组(n=84)、非重症组(n=121),另选取同期100名老年健康体检者为对照组;比较三组血清LDH、PCT、NLR水平,采用Pearson相关分析法分析血清LDH、PCT、NLR与患者病情程度[临床肺部感染评分(CPIS)、急性生理与慢性健康评分Ⅱ(APACHEⅡ)]的关系,绘制受试者工作特征(ROC)曲线评估血清LDH、PCT、NLR对重症肺炎预测价值;随访28 d,评估患者预后状态,并归纳预后的危险因素.结果重症组、非重症组血清LDH、PCT、NLR均高于对照组(P<0.05),且重症组均高于非重症组(P<0.05);血清LDH、PCT、NLR及三者联合预测重症肺炎的ROC曲线下面积分别为0.753、0.895、0.870和0.908;随访28 d,死亡42例,好转163例;PCT、NLR、CPIS评分及APACHEⅡ评分是老年肺炎预后的危险因素(P<0.05).结论老年肺炎患者血清LDH、PCT及NLR均升高,与患者病情程度有关,可作为重症肺炎的预测指标,其中PCT及NLR是患者死亡的危险因素.

OBJECTIVE To analyze the serum lactate dehydrogenase(LDH),procalcitonin(PCT)and neutrophil/lymphocyte ratio(NLR)in elderly patients with pneumonia and their relationship with disease severity and prognosis.METHODS Totally 205 elderly patients with pneumonia admitted to Hengshui People's Hospital from Jan.2019 to Sep.2022 were selected and divided into severe group(n=84)and non-severe group(n=121),and another 100 healthy elderly patients with physical examination during the same period were selected as control group.Serum LDH,PCT and NLR levels were compared among the three groups,and Pearson correlation analysis was used to analyze the relationship between serum LDH,PCT and NLR and disease severity[clinical pulmonary infection score(CPIS),acute physiological and chronic health evaluation II(APACHE II)].Receiver operating characteristic curve(ROC curve)was drawn to evaluate the predictive value of serum LDH,PCT and NLR for severe pneumonia.The patients were followed up for 28 days to evaluate the prognosis status,and the risk factors of prognosis were summarized.RESULTS The levels of serum LDH,PCT and NLR in severe group and non-severe group were higher than those in control group(P<0.05),and the levels in severe group were higher than those in non-severe group(P<O.05).The areas under ROC curves of serum LDH,PCT,NLR and combination of the three to predict severe pneumonia were 0.753,0.895,0.870,and 0.908,respectively.After 28 days of follow-up.42 cases died and 163 cases improved.PCT,NLR,CPIS score and APACHE II score were all risk factors for the prognosis of elderly pneumonia(P<O.05).CONCLUSION Serum LDH,PCT and NLR levels are all elevated in elderly patients with pneumonia,which are related to the disease severity of patients and can be used as predictors of severe pneumonia,with PCT and NLR being risk factors for death.