[目的]探讨中性粒细胞淋巴细胞比值(NLR)与老年社区获得性肺炎(CAP)患者病情严重程度和预后的关系.[方法]回顾性分析2016年7月到2018年1月本院诊治的103例老年CAP患者的临床资料.根据英国胸科协会改良肺炎(CURB‐65)评分分为低风险组( n...[目的]探讨中性粒细胞淋巴细胞比值(NLR)与老年社区获得性肺炎(CAP)患者病情严重程度和预后的关系.[方法]回顾性分析2016年7月到2018年1月本院诊治的103例老年CAP患者的临床资料.根据英国胸科协会改良肺炎(CURB‐65)评分分为低风险组( n =71)和高风险组( n =32);根据预后情况不同分为存活组( n =90)和死亡组( n =13).比较各组NLR 、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)及CURB‐65 ,并分析NLR与老年CAP患者病情严重程度和预后的关系.[结果]低风险组 NLR 、PCT 、CRP 、CURB‐65显著低于高风险组( P <0 .05),而两组WBC比较差异无统计学意义( P >0 .05);存活组NLR 、PCT 、CRP 、WBC水平及CURB‐65评分均显著低于死亡组( P <0 .05). Spearman相关性分析显示:NLR与PCT 、CRP 、CURB‐65均呈正相关( P <0 .05),而与WBC无相关性( P >0 .05 ). ROC分析显示:当截断值取5 .897时,NLR预测老年CAP死亡的曲线下面积、灵敏度和特异度分别为0 .803 、68%和85%.[结论]NLR对于老年CAP患者病情严重程度和预后具有良好的评估价值,NLR水平越高,提示病情越严重,且预后不佳.展开更多
Cognitive decline is a common complication after cardiac surgery with cardiopulmonary bypass（CPB）,but as such no pharmacological therapy has been shown to be efficacious in preventing the decline.However,gastrodin h...Cognitive decline is a common complication after cardiac surgery with cardiopulmonary bypass（CPB）,but as such no pharmacological therapy has been shown to be efficacious in preventing the decline.However,gastrodin has been shown to have multi-pharmacological effects on neurological functions.We undertook this study to test the hypothesis that gastrodin would potentially prevent CPB-associated neurocognitive decline.We randomly assigned 200 patients undergoing mitral valve replacement surgery to receive either gastrodin（40 mg/kg） or saline after the induction of anesthesia and subsequently evaluated cognitive function before surgery,at discharge,and at 3rd month after surgery by using a battery of five neurocognitive tests,or adverse effects of gastrodin postoperatively.Neurocognitive decline in postoperative function was defined as a drop of 1 SD or more in the scores on tests of any one of the four domains of cognitive function.Cognitive decline occurred in 9% of the patients in the gastrodin group in contrast to 42% in the control group（P〈0.01） at discharge.Cognitive outcome could be determined at 3rd month in 87 patients in the gastrodin group and 89 in the control group.Cognitive decline was detected in 6% in the gastrodin group and 31% in the control group（P〈0.01）.The incidences of possible adverse effects were similar between two groups.These results indicate that gastrodin is an effective and a safe drug for the prevention of neurocognitive decline in patients undergoing mitral valve replacement surgery with CPB.展开更多
文摘[目的]探讨中性粒细胞淋巴细胞比值(NLR)与老年社区获得性肺炎(CAP)患者病情严重程度和预后的关系.[方法]回顾性分析2016年7月到2018年1月本院诊治的103例老年CAP患者的临床资料.根据英国胸科协会改良肺炎(CURB‐65)评分分为低风险组( n =71)和高风险组( n =32);根据预后情况不同分为存活组( n =90)和死亡组( n =13).比较各组NLR 、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)及CURB‐65 ,并分析NLR与老年CAP患者病情严重程度和预后的关系.[结果]低风险组 NLR 、PCT 、CRP 、CURB‐65显著低于高风险组( P <0 .05),而两组WBC比较差异无统计学意义( P >0 .05);存活组NLR 、PCT 、CRP 、WBC水平及CURB‐65评分均显著低于死亡组( P <0 .05). Spearman相关性分析显示:NLR与PCT 、CRP 、CURB‐65均呈正相关( P <0 .05),而与WBC无相关性( P >0 .05 ). ROC分析显示:当截断值取5 .897时,NLR预测老年CAP死亡的曲线下面积、灵敏度和特异度分别为0 .803 、68%和85%.[结论]NLR对于老年CAP患者病情严重程度和预后具有良好的评估价值,NLR水平越高,提示病情越严重,且预后不佳.
基金supported partly by grants from the National Natural Sciences Foundation of China (No. 30271255)the Natural Sciences Foundation of Hubei Province, China (No. 2006ABB023)
文摘Cognitive decline is a common complication after cardiac surgery with cardiopulmonary bypass（CPB）,but as such no pharmacological therapy has been shown to be efficacious in preventing the decline.However,gastrodin has been shown to have multi-pharmacological effects on neurological functions.We undertook this study to test the hypothesis that gastrodin would potentially prevent CPB-associated neurocognitive decline.We randomly assigned 200 patients undergoing mitral valve replacement surgery to receive either gastrodin（40 mg/kg） or saline after the induction of anesthesia and subsequently evaluated cognitive function before surgery,at discharge,and at 3rd month after surgery by using a battery of five neurocognitive tests,or adverse effects of gastrodin postoperatively.Neurocognitive decline in postoperative function was defined as a drop of 1 SD or more in the scores on tests of any one of the four domains of cognitive function.Cognitive decline occurred in 9% of the patients in the gastrodin group in contrast to 42% in the control group（P〈0.01） at discharge.Cognitive outcome could be determined at 3rd month in 87 patients in the gastrodin group and 89 in the control group.Cognitive decline was detected in 6% in the gastrodin group and 31% in the control group（P〈0.01）.The incidences of possible adverse effects were similar between two groups.These results indicate that gastrodin is an effective and a safe drug for the prevention of neurocognitive decline in patients undergoing mitral valve replacement surgery with CPB.
