摘要
目的探讨甲型流行性感冒病毒感染的患者外周血淋巴细胞衍生参数[全身免疫炎症指数(SII,即血小板×中性粒细胞与淋巴细胞比率)、中性粒细胞与淋巴细胞比率(NLR)、血小板与淋巴细胞比率(PLR)、C反应蛋白与淋巴细胞比率(CLR)]在早期识别肺炎发生中的作用。方法回顾性收集2023年10月至2024年10月期间在空军军医大学唐都医院收治的甲型流行性感冒病毒感染的住院患者的临床资料,其中无肺炎组101例,肺炎组106例。结果甲型流行性感冒病毒肺炎组患者的平均年龄更高,伴有咳嗽症状更多,C反应蛋白(CRP)、D二聚体、白细胞、中性粒细胞等炎症指标水平显著升高,淋巴细胞减少和嗜酸性粒细胞水平降低。外周血淋巴细胞衍生参数SII、NLR、PLR以及CLR在肺炎组患者中显著升高且与CRP的表达水平呈正相关。ROC分析结果显示,SII、NLR、PLR以及CLR的AUC值及其95%CI分别为0.654(0.579~0.728)、0.670(0.596~0.743)、0.620(0.544~0.696)以及0.667(0.593~0.740),联合应用时AUC值及其95%CI达到了0.702(0.631~0.773),这一结果明显超过了单一参数的诊断效益。结论外周血淋巴细胞衍生参数SII、NLR、PLR以及CLR在早期识别甲型流行性感冒病毒感染的患者是否出现肺炎方面具有应用价值。
Objective To explore the role of peripheral blood lymphocyte-derived parameters[systemic immune-inflammation index(SII),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and C-reactive protein to lymphocyte ratio(CLR)]in the early identification of pneumonia in patients infected with influenza A virus.Methods A retrospective collection of clinical data from hospitalized patients with influenza A virus infection at Tangdu Hospital,Air Force Medical University from October 2023 to October 2024 was conducted.There were 101 cases in the non-pneumonia group and 106 cases in the pneumonia group.Results Patients in the influenza A virus pneumonia group had a higher average age and more frequent cough symptoms.Inflammatory markers such as C-reactive protein(CRP),D-dimer,white blood cells,and neutrophils were significantly elevated,while lymphocytes and eosinophil levels were decreased.Peripheral blood lymphocyte-derived parameters SII,NLR,PLR,and CLR were significantly increased in the pneumonia group and positively correlated with the expression levels of CRP.ROC analysis showed that the AUC values and their 95%CI for SII,NLR,PLR,and CLR were 0.654(0.5790.728),0.670(0.5960.743),0.620(0.5440.696),and 0.667(0.5930.740),respectively.When used in combination,the AUC value and its 95%CI reached 0.702(0.6310.773),which significantly exceeded the diagnostic benefit of a single parameter.Conclusion Peripheral blood lymphocyte-derived parameters SII,NLR,PLR,and CLR have application value in the early identification of pneumonia in patients infected with influenza A virus.
作者
高富国
高永恒
金发光
GAO Fuguo;GAO Yongheng;JIN Faguang(Department of Respiratory and Critical Care Medicine,Tangdu Hospital,Air Force Medical University,Xi an 710038,China)
出处
《空军军医大学学报》
2025年第6期733-738,共6页
Journal of Air Force Medical University
基金
国家自然科学基金面上项目(82270084)
陕西省重点产业链项目(2022ZDLSF01-10)。
作者简介
高富国,硕士研究生,从事呼吸系统疾病研究,Tel:15691867585,E-mail:gaofuguo@fmmu.edu.cn;通信作者:金发光,Tel:13991803305,E-mail:jinfag@fmmu.edu.cn。
