摘要
目的 探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和中性粒细胞与淋巴细胞比值(NLR)对革兰阴性菌感染重症肺炎患者的早期鉴别诊断和预后价值。方法 选取该院2021年8月至2022年8月收治的98例革兰阴性菌感染的重症肺炎患者为研究对象,根据细菌培养结果分为肠杆菌组(51例)与非发酵菌组(47例);根据患者预后分为预后不佳组(38例)和预后良好组(60例)。选取同期于该院进行体检的50名体检健康者为健康对照组(50例)。采集患者痰液标本,采用全自动细菌分析仪进行细菌鉴定。采集受试者血清,采用酶联免疫吸附试验检测NGAL水平,计算NLR。采用受试者工作特征(ROC)曲线对NGAL、NLR诊断革兰阴性菌感染重症肺炎的价值进行分析。结果 肠杆菌组NGAL水平高于非发酵菌组(P<0.05),非发酵组NGAL水平高于健康对照组(P<0.05);肠杆菌组NLR与非发酵菌组比较,差异无统计学意义(P>0.05);预后不佳组患者NGAL水平、NLR高于预后良好组(P<0.05);NGAL、NLR及二者联合检测革兰阴性菌感染重症肺炎的曲线下面积分别为0.702(95%CI 0.590~0.814)、0.707(95%CI 0.604~0.811)、0.758(95%CI 0.660~0.856),联合检测诊断效能更高。结论 NGAL对早期鉴别肠杆菌与非发酵菌感染的重症肺炎患者有指导意义,NGAL和NLR对评估革兰阴性菌感染的重症肺炎患者预后有一定的参考价值。
Objective To investigate the early differential diagnosis and prognostic value of neutrophil gelatinase-associated lipocalin(NGAL)and neutrophil to lymphocyte ratio(NLR)in patients with severe pneumonia caused by Gram-negative bacteria.Methods A total of 98 patients with severe pneumonia caused by Gram-negative bacteria admitted to this hospital from August 2021 to August 2022 were selected as the research objects.According to the results of bacterial culture,they were divided into enterobacteriaceae group(51 cases)and non-fermentative bacteria group(47 cases).According to the prognosis,the patients were divided into poor prognosis group(38 cases)and good prognosis group(60 cases).A total of 50 healthy people who underwent physical examination in the hospital during the same period were selected as the healthy control group(50 cases).Sputum samples were collected from patients,and bacteria were identified by automatic bacterial analyzer.Serum NGAL levels were measured by enzyme-linked immunosorbent assay,and NLR was calculated.Receiver operating characteristic(ROC)curve was used to analyze the value of NGAL and NLR in the diagnosis of severe pneumonia caused by Gram-negative bacteria.Results The level of NGAL in enterobacteriaceae group was higher than that in non-fermentative bacteria group(P<0.05),and the level of NGAL in non-fermentative bacteria group was higher than that in healthy control group(P<0.05).There was no significant difference in NLR between enterobacteriaceae group and non-fermentative bacteria group(P>0.05).The NGAL level and NLR in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The area under the curve of NGAL,NLR and their combination were 0.702(95%CI 0.590-0.814),0.707(95%CI 0.604-0.811)and 0.758(95%CI 0.660-0.856),respectively.The diagnostic efficiency of combined detection was higher.Conclusion NGAL has a guiding significance for early differentiation of severe pneumonia patients caused by Enterobacteriaceae and non-fermentative bacteria.NGAL and NLR have a certain reference value for evaluating the prognosis of severe pneumonia patients caused by Gram-negative bacteria.
作者
王珊珊
刘周
周强
WANG Shanshan;LIU Zhou;ZHOU Qiang(Department of Clinical Laboratory,the Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)
出处
《国际检验医学杂志》
CAS
2023年第12期1442-1445,共4页
International Journal of Laboratory Medicine
基金
安徽省高校自然科学研究重大项目(KJ2021ZD0029)
安徽省转化医学研究院科研基金项目(2021zhyx-C47)。
