| 程森中,胡波,曹琴,等.中性粒细胞/淋巴细胞比值和纤维蛋白原检测对呼吸机相关性肺炎的诊断价值[J].安徽医药,2020,24(12):2394-2398. |
| 中性粒细胞/淋巴细胞比值和纤维蛋白原检测对呼吸机相关性肺炎的诊断价值 |
| Diagnostic values of neutrophil/lymphocyte and fibrinogen detection in ventilator?associated pneumonia in patients undergoing mechanical ventilation |
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| DOI：10.3969/j.issn.1009?6469.2020.12.016 |
| 中文关键词: 肺炎，呼吸机相关性 呼吸，人工 中性粒细胞 /淋巴细胞 纤维蛋白原 诊断 |
| 英文关键词: Pneumonia,ventilator?associated Respiration,artificial Neutrophil/lymphocyte Fibrinogen Diagnostic |
| 基金项目:四川省科技厅项目(2017FZ0064) |
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| 中文摘要: |
| 目的探究中性粒细胞 /淋巴细胞(NLR)和纤维蛋白原(FIB)水平在机械通气病人发生呼吸机相关性肺炎(VAP)中的诊断价值。方法选取 2018年 2月至 2019年 2月在四川绵阳四〇四医院 152例重症监护室机械通气病人，根据是否发生 VAP分为 VAP组(72例)与非 VAP组(80例)，血细胞分析仪检测 NLR，酶联免疫吸附试验(ELISA)检测血清中 FIB水平， logistic分析影响机械通气病人发生 VAP的危险因素；采取受试者工作特征曲线(ROC)评估 NLR、FIB在 VAP中的诊断价值，并比较单项检测与联合检测诊断效能。结果 VAP组 COPD例数、通气时间、急性生理学与慢性健康状况评分系统 Ⅱ(APACHEⅡ)评分、有创通气例数均显著高于非 VAP组(P＜0.05)。与非 VAP组(3.15±0.94)、(2.39±0.59)g/L比较， VAP组病人血清 NLR、FIB水平(6.41±1.38)、(3.27±0.75)g/L显著升高；随着病情风险程度的升高， VAP病人血清 NLR、FIB水平升高(P＜0.05)。通气时间、 APACHEⅡ评分、 NLR、FIB为影响机械通气病人发生 VAP的独立危险因素(P＜0.05)。 NLR对 VAP预测的曲线下面积(AUC)值为 0.810(95%CI:0.738~0.869)； FIB对 VAP预测的 AUC值为 0.767(95%CI:0.692~0.832)。 NLR联合 FIB诊断机械通气病人 VAP的灵敏度显著高于 NLR、FIB单项检测(P＜0.05)。结论 NLR、FIB为影响机械通气病人发生 VAP的危险因素。两者在机械通气病人 VAP的发生中具有一定的诊断价值，联合检测后诊断效能更优。 |
| 英文摘要: |
| Objective To explore the diagnostic values of neutrophil/lymphocyte(NLR)and fibrinogen(FIB)level in ventilator?as? sociated pneumonia(VAP)in mechanical ventilation patients.Methods A total of 152 patients were treated with mechanical ven?tilation in ICU of No.404 Hospital of Mianyang from February 2018 to February 2019 and assigned into VAP group(72 cases)and non?VAP group(80 cases)according to the occurrence of VAP.NLR was detected by blood cell analyzer，the level of FIB in serum was detected by enzyme linked immunosorbent assay(ELISA).Logistic analysis was used to analyze the risk factors of VAP in pa?tients with mechanical ventilation.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic values of NLR and FIB in VAP，and the diagnostic efficacies of single test and joint test were compared.Results The number of COPD cases， ventilation time，acute physiology and chronic health score system Ⅱ(APACHE Ⅱ)score and number of invasive ventilation cas? es in VAP group were significantly higher than those in non?VAP group(P＜0.05).Compared with non?VAP group［(3.15±0.94) and(2.39±0.59)g/L］，serum NLR and FIB levels in VAP group were(6.41±1.38)and(3.27±0.75)g/L，which were significantlyincreased.The levels of NLR and FIB in the VAP group increased with the increase in the risk of illness(P＜0.05).Ventilation time，APACHEⅡ score，NLR and FIB were independent risk factors for VAP in patients with mechanical ventilation(P＜0.05). The area under the curve(AUC)value of NLR for predicting VAP was 0.810(95%CI:0.738-0.869)，and the AUC value of FIB for predicting VAP was 0.767(95%CI:0.692-0.832).The sensitivity of NLR combined with FIB in the diagnosis of VAP in me?chanical ventilation patients was significantly higher than that of NLR or FIB(P＜0.05).Conclusions NLR and FIB are risk fac? tors for VAP in mechanical ventilation patients，and they have certain diagnostic value in the occurrence of VAP in mechanical ven?tilation patients.The diagnostic efficiency of combined detection is better. |
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