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Received:October 14, 2021 Published Online:May 20, 2022
Received:October 14, 2021 Published Online:May 20, 2022
中文摘要: 目的 探讨中性粒细胞－淋巴细胞比值（NLR）和系统免疫炎症指数（SII）对老年社区获得性肺炎合并营养不良患者预后的评估价值。方法 选取2020年4月至2021年4月在连云港市第二人民医院老年科住院的107例诊断为社区获得性肺炎且微型营养评定量表（MNA-SF）评分≤7分的老年患者进行回顾性研究。检测血常规并计算SII和NLR，随访28 d，根据不同临床转归，分为死亡组（ n =15）和生存组（ n =92）。评估SII和NLR对预后的预测价值并筛选影响预后的危险因素。结果 与存活组相比，死亡组的MNA-SF评分低，SII和NLR高（P<0.05）。MNA-SF评分与Charlson共病指数、SII、NLR均呈负相关（ r =-0.511、-0.418、-0.530，P<0.05）。SII、NLR评估老年社区获得性肺炎合并营养不良患者预后的AUC分别为0.909、0.927。Logistic回归分析显示，MNA-SF评分［ OR =5.073，95% CI (1.383,18.602)］和SII［ OR =21.170，95% CI (1.056,424.282)］是影响老年社区获得性肺炎合并营养不良患者预后的独立影响因素（P<0.05）。结论 SII和NLR对老年社区获得性肺炎合并营养不良患者预后有一定的预测价值。临床工作中应重视营养评估与干预。
中文关键词: 社区获得性肺炎 营养不良 系统免疫炎症指数 中性粒细胞-淋巴细胞比值
Abstract:Objective To investigate the value of neutrophil-lymphocyte ratio(NLR) and systemic immune inflammation index(SII)in evaluating the prognosis of elderly patients with community-acquired pneumonia complicated with malnutrition. Methods A retrospective study was conducted on 107 patients hospitalized in the Second People's Hospital of Lianyungang from April 2020 to April 2021, who were more than 60 years old and diagnosed with community-acquired pneumonia complicated with the short-form mini-nutritional assessment(MNA-SF) score less than 7. The patients were divided into death group（ n =15） and survival group（ n =92） according to different clinical outcomes after 28 days of follow-up, and SII and NLR were calculated based on blood routine test. The predictive value of SII and NLR for prognosis was evaluated, and the risk factors influencing prognosis were determined. Results Compared to the survival group, the MNA-SF score was lower, and the SII and NLR were higher in death grouP(P<0.05). MNA-SF score was negatively correlated with Charlson comorbidities index, SII and NLR ( r =-0.511, -0.418, -0.530, P<0.05), respectively. The AUC of SII and NLR in evaluating the prognosis were 0.909 and 0.927, respectively. Logistic regression analysis showed that MNA-SF score ［ OR =5.073，95% CI (1.383,18.602)］and SII［ OR =21.170，95% CI (1.056,424.282)］ were the independent factors for evaluating the prognosis of elderly patients with community-acquired pneumonia complicated with malnutrition （P<0.05）. Conclusions SII and NLR have certain predictive value for the prognosis of elderly patients with community-acquired pneumonia complicated with malnutrition. More attention should be paid to nutrition assessment and intervention.
keywords: Community-acquired pneumonia Malnutrition Systemic immune inflammation index Neutrophil-lymphocyte ratio
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