降钙素原与中性粒细胞淋巴细胞计数比值在COPD急性加重期细菌感染的诊断价值

发布时间：2018-08-12 10:03

【摘要】：目的探讨降钙素原(PCT)与中性粒细胞淋巴细胞计数比值(NLR)在慢性阻塞性肺病(COPD)急性加重期细菌感染的诊断价值,为其临床研究提供参考依据。方法选择2015年3月-2016年5月188例怀疑细菌感染的COPD急性加重期患者作为研究对象,所有患者均空腹抽取静脉血检测PCT及NLR值;以痰液培养结果为金标准,采用ROC曲线分析PCT及NLR单独与联合对COPD急性加重期细菌感染的诊断价值。结果 188例怀疑细菌感染的COPD急性加重期患者中,痰培养细菌感染146例占77.7%,非细菌感染42例占22.3%;细菌组WBC、NEUT、NLR及PCT均高于非细菌组,差异有统计学意义(P0.05);以痰培养结果为金标准绘制ROC曲线发现,WBC的AUC面积为0.614,截断值为10.39,灵敏度为47.9%,特异度为52.4%;NEUT的AUC面积为0.637,截断值为0.63,灵敏度为50.0%,特异度为59.5%;NLR的AUC面积为0.776,截断值为2.10,灵敏度为81.5%,特异度为71.4%;PCT的AUC面积为0.898,截断值为0.97,灵敏度为89.0%,特异度为85.7%;PCT联合NLR并联漏诊率最低为2.0%,PCT联合NLR串联误诊率最低为4.1%。结论 PCT并联NLR诊断COPD急性加重期细菌感染的漏诊率较低。
[Abstract]:Objective to investigate the diagnostic value of calcitonin proto (PCT) / neutrophil lymphocyte count ratio (NLR) in acute exacerbation of chronic obstructive pulmonary disease (COPD) and to provide reference for its clinical study. Methods from March 2015 to May 2016, 188 patients with acute exacerbation of COPD with suspected bacterial infection were selected as the study subjects. The fasting venous blood samples were taken from all patients to detect the PCT and NLR values, and the sputum culture results were taken as the gold standard. ROC curve was used to analyze the diagnostic value of PCT and NLR alone and combined in acute exacerbation of COPD bacterial infection. Results among the 188 COPD patients suspected of bacterial infection, 146 cases were sputum culture bacterial infection (77.7%), 42 cases were non-bacterial infection (22.3C), and the bacterial group (WBC C net NLR and PCT) were higher than non-bacterial group (P < 0.05). The AUC area, truncation value, sensitivity, specificity and specificity of ROC were 0.614, 10.39, 47.9, 0.637, 0.637, 0.63, 50.0 and 59.5%, respectively, respectively. The results of sputum culture showed that the AUC area was 0.614, the truncation value was 10.39, the sensitivity was 47.9, the specificity was 0.637, the truncation value was 0.63, the sensitivity was 50.0 and the specificity was 59.5%. The AUC area was 0.776, the truncation value was 2.10, the sensitivity was 81.5, the specificity was 71.4, the AUC area was 0.898, the truncation value was 0.97, the sensitivity was 89.0, and the specificity was 85.7 PCT and NLR parallel misdiagnosis. Conclusion the rate of missed diagnosis of bacterial infection in acute exacerbation of COPD by PCT parallel NLR is low.
【作者单位】：新乡市第一人民医院呼吸与危重症科;郑州市第十五医院内一科;首都医科大学附属北京朝阳医院呼吸与危重症医学科;
【基金】：国家自然科学基金资助项目(8140003)
【分类号】：R563.9

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