血NT-proBNP CRP和NLR水平在评估慢性阻塞性肺疾病急性加重合并肺部感染患者预后的价值

doi:10.3969/j.issn.1006-6233.2024.02.010

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摘要 目的: 探究血N-末端脑钠肽前体(NT-proBNP)、C-反应蛋白(CRP)和嗜中性粒细胞与淋巴细胞比值(NLR)水平在评估慢性阻塞性肺疾病急性加重(AECOPD)合并肺部感染患者预后中的价值。方法: 选择2019年12月至2021年12月医院收治的120例AECOPD合并肺部感染患者的临床资料进行回顾性分析,根据患者预后情况将其分为存活组(n=86)与死亡组(n=34),比较两组一般资料,血NT-proBNP、CRP和NLR水平,三者在评估患者预后中的价值用受试者工作曲线(ROC)进行分析。结果: 存活组血NT-proBNP、CRP和NLR水平均低于死亡组(P<0.05);采用ROC曲线分析结果显示:NLR的曲线下面积值(AUC)值最高,敏感度、特异度分别为73.53%、63.95%,以CRP的AUC值最低,敏感度、特异度分别为47.06%、82.56%(P>0.05),血NT-proBNP、CRP、NLR并联诊断后AUC为0.700,敏感度升高,为97.06%,特异度为43.02%。结论: 血NT-proBNP、CRP和NLR在AECOPD合并肺部感染患者预后评估中具有较高的价值,临床可将NT-proBNP、CRP和NLR作为辅助判定指标对患者病情进行预测以改善患者预后。

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关键词 ：慢性阻塞性肺疾病, 肺部感染, N-末端脑钠肽前体, C-反应蛋白, 嗜中性粒细胞与淋巴细胞比值

Abstract：Objective: To investigate the prognostic value of blood N-terminal prohormone of brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in patients with AECOPD and pulmonary infection. Methods: From December 2019 to December 2021, 120 patients with AECOPD and pulmonary infection were admitted to the hospital. Their clinical data were analyzed retrospectively. Patients enrolled were divided into survival group (n=86) and death group (n=34) according to the prognosis. General data, blood NT-proBNP, CRP and NLR were compared. The prognostic value of the three in patients with AECOPD and pulmonary infection was analyzed using the receiver operating characteristic (ROC) curve. Results: Compared with the death group, blood NT-proBNP, CRP and NLR in the survival group were lower (P<0.05). ROC curve analysis results showed that the area under the curve (AUC) of NLR for predicting the prognosis of patients with AECOPD and pulmonary infection was the largest, with sensitivity of 73.53% and specificity of 63.95%. The AUC of CRP was the smallest, with sensitivity of 47.06% and specificity of 82.56% (P>0.05). The AUC of parallel prediction with the combination of blood NT-proBNP, CRP and NLR was 0.700. The sensitivity and specificity were 97.06% and 43.02%. Conclusion: Blood NT-proBNP, CRP and NLR are of high value in the prognosis of patients with AECOPD and pulmonary infection. In clinical practice, NT-proBNP, CRP and NLR can be used as auxiliary indicators to predict the patient's condition, thus improving the prognosis.

Key words： Chronic obstructive pulmonary disease Pulmonary infection N-terminal prohormone of brain natriuretic peptide C-reactive protein Neutrophil to lymphocyte ratio

基金资助:山西省医学重点科研项目,(编号:2021XM19)

通讯作者: 马小军

引用本文:

武琴琴, 王艳艳, 李佳, 常琴, 郭淑明, 马小军. 血NT-proBNP CRP和NLR水平在评估慢性阻塞性肺疾病急性加重合并肺部感染患者预后的价值[J]. 河北医学, 2024, 30(2): 230-234.
WU Qinqin, WANG Yanyan, LI Jia, et al. Prognostic Value of Blood NT-proBNP CRP and NLR in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Pulmonary Infection. HeBei Med, 2024, 30(2): 230-234.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.02.010 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I2/230

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