摘要
目的 探讨血细胞计数指标和炎症指标在肺结核合并肺部感染患者中的诊断价值.方法 收集 2022 年 1 月—2023 年 6 月沧州市第三医院收治的 231 例肺结核患者的临床资料,根据有无肺部细菌感染分为阳性组(117 例)和对照组(114 例);其中 105 例白细胞正常,108 例淋巴细胞减少.比较两组中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)以及红细胞沉降率(ESR)、C-反应蛋白(CRP)、降钙素原(PCT)水平.绘制受试者工作特征曲线(ROC曲线)并计算ROC曲线下面积(AUC),评估各指标对肺结核合并肺部感染的诊断效能.结果 阳性组患者NLR、MLR、PLR、ESR、CRP、PCT水平均显著高于对照组[NLR:4.27(2.67,8.38)比 2.90(1.89,4.42);MLR:0.52(0.32,0.85)比 0.31(0.21,0.47);PLR:216.67(143.19,342.63)比 177.70(124.90,281.89);ESR(mm/h):24.50(10.00,41.50)比 14.50(4.75,28.25);CRP(mg/L):31.20(13.28,90.03)比 11.30(2.45,39.15);PCT(μg/L):0.10(0.10,0.45)比 0.10(0.10,0.16);均P<0.05].在白细胞正常患者和淋巴细胞减少患者中,各指标诊断肺结核合并肺部感染的AUC均>0.5.结论 NLR、MLR、PLR对断肺结核合并肺部感染的诊断价值优于ESR、CRP、PCT,是简便、快速、价廉的早期辅助诊断指标.
Abstract
Objective To explore the diagnostic value of blood cell count and inflammatory indicators in patients with pulmonary tuberculosis complicated with pulmonary infection.Methods The clinical data of 231 patients diagnosed with pulmonary tuberculosis admitted to Cangzhou Third Hospital from January 2022 to June 2023 were collected,and the patients were divided into positive group(117 cases)and control group(114 cases)based on presence of pulmonary bacterial infection.Among them,105 cases had normal white blood cell count(WBC)and 108 cases had decreased lymphocyte count(LYM).The levels of neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),platelet to lymphocyte ratio(PLR),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and procalcitonin(PCT)between two groups were compared.The receiver operator characteristic(ROC)curve was drawn and the area under ROC curve(AUC)was calculated to evaluate the diagnostic efficacy of each indicator.Results The levels of NLR,MLR,PLR,ESR,CRP and PCT in positive group were higher than those in control group[NLR:4.27(2.67,8.38)vs.2.90(1.89,4.42);MLR:0.52(0.32,0.85)vs.0.31(0.21,0.47);PLR:216.67(143.19,342.63)vs.177.70(124.90,281.89);ESR(mm/h):24.50(10.00,41.50)vs.14.50(4.75,28.25);CRP(mg/L):31.20(13.28,90.03)vs.11.30(2.45,39.15);PCT(μg/L):0.10(0.10,0.45)vs.0.10(0.10,0.16);all P<0.05].In patients with normal WBC and those with decreased LYM,the AUC of all indicators was>0.5.Conclusion The diagnostic value of NLR,MLR and PLR for pulmonary tuberculosis combined with pulmonary infection is superior to ESR,CRP and PCT,and they are simple,fast and cost-effective early auxiliary diagnostic indicators.
基金项目
河北省沧州市科技计划自筹项目(222106069)
维普
万方数据