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血液肝素结合蛋白和中性粒细胞与淋巴细胞比值作为社区获得性肺炎严重程度和预后的指标。

Blood heparin-binding protein and neutrophil-to-lymphocyte ratio as indicators of the severity and prognosis of community-acquired pneumonia.

作者信息

Meng Yue, Zhang Ling, Huang Mingyue, Sun Gengyun

机构信息

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

Department of Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

出版信息

Respir Med. 2023 Mar;208:107144. doi: 10.1016/j.rmed.2023.107144. Epub 2023 Feb 2.

Abstract

BACKGROUND

Community-acquired pneumonia (CAP) is particularly prevalent and has high mortality in severely ill patients, but the role of current biomarkers is limited. This study aimed to evaluate the importance of blood heparin-binding protein (HBP) and neutrophil-to-lymphocyte ratio (NLR) in assessing the severity and prognosis of CAP in adults.

METHODS

The clinical information of 206 CAP patients was retrospectively analyzed. Receiver operating characteristic (ROC) curves were created, and the accuracy of the diagnosis of severe pneumonia was evaluated by the area under the curve (AUC). Univariate and multivariate Cox regression analysis was used to examine independent factors affecting the 30-day prognosis. The Kruskal-Wallis test was utilized to contrast the variations among etiology.

RESULTS

Patients with severe pneumonia showed greater HBP and NLR compared to those with common pneumonia. The AUC of HBP was 0.723 (95% CI: 0.655-0.790) for the diagnosis of severe pneumonia, while NLR and HBP exhibited superior sensitivity (80.00%) and specificity (76.19%), respectively. Their combination boosted the diagnostic specificity (84.13%) while increasing the diagnostic sensitivity (86.25%) when combined with white blood cell (WBC) count. The 30-day mortality in CAP patients was independently predicted by HBP and NLR. However, there were no appreciable differences in HBP amongst patients with various etiologies.

CONCLUSION

HBP and NLR were also independent predictors of 30-day death in CAP patients and grew with increasing severity in these patients. Their combination opened up new possibilities. Furthermore, there is no connection between HBP and the etiology of CAP.

摘要

背景

社区获得性肺炎(CAP)在重症患者中尤为普遍且死亡率高,但目前生物标志物的作用有限。本研究旨在评估血液肝素结合蛋白(HBP)和中性粒细胞与淋巴细胞比值(NLR)在评估成人CAP严重程度和预后中的重要性。

方法

回顾性分析206例CAP患者的临床资料。绘制受试者工作特征(ROC)曲线,通过曲线下面积(AUC)评估重症肺炎诊断的准确性。采用单因素和多因素Cox回归分析来检验影响30天预后的独立因素。利用Kruskal-Wallis检验对比病因之间的差异。

结果

与普通肺炎患者相比,重症肺炎患者的HBP和NLR更高。HBP诊断重症肺炎的AUC为0.723(95%CI:0.655 - 0.790),而NLR和HBP的敏感性(分别为80.00%)和特异性(分别为76.19%)表现更佳。与白细胞(WBC)计数联合时,它们的组合提高了诊断特异性(84.13%),同时增加了诊断敏感性(86.25%)。CAP患者的30天死亡率由HBP和NLR独立预测。然而,不同病因患者之间的HBP没有明显差异。

结论

HBP和NLR也是CAP患者30天死亡的独立预测因素,且在这些患者中随病情严重程度增加而升高。它们的组合开辟了新的可能性。此外,HBP与CAP的病因之间没有关联。

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