中性粒细胞与白蛋白比值联合A-DROP评分对重症社区获得性肺炎预后有评估价值

李翠翠.中性粒细胞与白蛋白比值联合A-DROP评分对重症社区获得性肺炎预后有评估价值[J].内科急危重症杂志,2024,30(5):422-424

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DOI：10.11768/nkjwzzzz.20240509

中文关键词: 重症社区获得性肺炎中性粒细胞与白蛋白比值 A-DROP评分预后

英文关键词:

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作者	单位	E-mail
李翠翠	沧州市人民医院	licc6233@163.com

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中文摘要:

摘要目的：探讨中性粒细胞与白蛋白比值（NAR）联合A-DROP评分对重症社区获得性肺炎（SCAP）患者预后的评估价值。方法：收集73例SCAP患者的临床资料，根据SCAP患者入院30d内的生存状态，将其分为生存组（40例）和死亡组（33例），比较2组患者的临床指标，Spearman法分析SCAP患者的NAR与A-DROP评分的相关性，采用多因素Logistic回归模型分析影响SCAP预后的因素，应用受试者工作特征（ROC）曲线分析NAR联合A-DROP评分对SCAP患者预后的评估价值。结果：死亡组患者的NAR和A-DROP评分显著高于生存组，白蛋白水平、淋巴细胞计数、氧合指数和动脉氧分压（PaO2）显著低于生存组（P均<0.05）。SCAP患者的NAR与A-DROP评分呈正相关（r=0.425，P<0.05），NAR和A-DROP评分可作为SCAP患者入院30d预后的独立危险因素（P均<0.05）。NAR和A-DROP评分单独及联合预测SCAP患者入院30d预后的AUC分别为0.813（95%CI 0.715~0.911）、0.836（95%CI 0.736~0.935）、0.908（95%CI 0.834~0.981）。结论：NAR和A-DROP评分可以作为预测SCAP患者入院30d预后的独立危险因素，且NAR联合A-DROP评分能够提高预测价值。

英文摘要:

Abstract Objective: To investigate the prognostic value of neutrophil to albumin ratio (NAR) combined with A-DROP score in patients with severe community-acquired pneumonia (SCAP). Methods: The clinical data of 73 SCAP patients were collected, and the SCAP patients were divided into the survival group (40 patients) and the death group (33 patients) according to their survival status within 30 days of hospitalization. The clinical indexes of patients in the 2 groups were compared, Spearman's method was used to analyze the correlation between NAR and A-DROP scores in SCAP patients, multifactorial logistic regression model was used to predict the factors affecting the prognosis of SCAP, and ROC curves were applied to analyze the value of NAR combined with A-DROP scores in assessing the prognosis of SCAP patients. Results: NAR and A-DROP scores in the death group were significantly higher than those in the survival group, and albumin levels, lymphocyte counts, oxygenation index, and partial pressure of arterial oxygen (PaO2) were significantly lower than those in the survival group (all P<0.05). NAR and A-DROP scores were positively correlated in SCAP patients (r=0.425, P<0.05), and NAR and A-DROP scores could serve as independent risk factors for the prognosis of SCAP patients at 30 days of admission (all P<0.05). The AUCs of NAR and A-DROP scores alone and in combination for predicting 30 days admission prognosis in SCAP patients were 0.813 (95% CI: 0.715-0.911), 0.836 (95% CI: 0.736-0.935), and 0.908 (95% CI: 0.834-0.981), respectively. Conclusion: NAR and A-DROP score can be used as independent risk factors for predicting the 30-day prognosis of SCAP patients, and the combination of NAR and A-DROP score can improve the predictive value.