内科

目的探讨血清血小板/淋巴细胞比值（PLR）、血清C反应蛋白/白蛋白比值（CRP/ALB）、血清中性粒细胞/淋巴细胞比率（NLR）对脑卒中相关性肺炎（SAP）患者预后的预测价值。方法选取71例脑卒中患者作为研究对象，按照是否发生SAP将其分为SAP组（n=31）与非SAP组（n=40），另选取同期于罗定市人民医院行常规体检的35名健康体检者为对照组。比较SAP组、非SAP组、对照组的血清PLR、CRP/ALB、NLR水平。将SAP组患者按随访3年期间的存活情况分为存活组（n=22）与死亡组（n=9），比较两组血清PLR、CRP/ALB、NLR水平。应用多因素logistic回归模型分析SAP患者预后的影响因素。绘制受试者操作特征（ROC）曲线分析血清PLR、CRP/ALB、NLR水平单独和联合预测SAP患者预后的价值。结果SAP组血清PLR、CRP/ALB、NLR水平均高于非SAP组与对照组，死亡组血清PLR、CRP/ALB、NLR水平均高于存活组（均P＜0.05）。多因素logistic回归分析结果显示：血清PLR、CRP/ALB、NLR水平升高均是SAP患者死亡的独立危险因素（均P＜0.05）。ROC曲线分析结果显示：血清PLR、CRP/ALB、NLR水平联合预测SAP患者死亡的曲线下面积（0.934）大于三项指标单独预测（分别为0.838、0.823、0.768）。结论血清PLR、CRP/ALB、NLR水平升高是SAP患者长期预后不佳(死亡)的独立危险因素，三项指标联合预测SAP患者长期预后的临床价值较高。

ObjectiveTo investigate the value of serum platelet/lymphocyte ratio (PLR), serum C-reactive protein/albumin ratio (CRP/ALB), and serum neutrophil/lymphocyte ratio (NLR) in predicting the prognosis of patients with stroke-related pneumonia (SAP). MethodsA total of 71 stroke patients were selected as research subjects and divided into an SAP group (n=31) or a non-SAP group (n=40) according to the occurrence of SAP, and 35 healthy physical examinees who underwent routine physical examination in Luoding People′s Hospital during the same period were selected as the control group. The serum PLR, CRP/ALB, and NLR levels were compared between the SAP group, non-SAP group, and control group. The patients in the SAP group were subdivided into a survival group (n=22) or a death group (n=9) according to their survival during the 3-year follow-up period, and the serum PLR, CRP/ALB, and NLR levels were compared between the two groups. The multivariate logistic regression model was applied to analyze factors influencing SAP patients′ prognosis. Receiver operating characteristic (ROC) curves were drawn to analyze the value of serum PLR, CRP/ALB, and NLR levels, alone and in combination, in predicting SAP patients′ prognosis. ResultsThe serum levels of PLR, CRP/ALB, and NLR in the SAP group were higher than those in the non-SAP group and the control group, and the serum levels of PLR, CRP/ALB, and NLR in the death group were higher than those in the survival group (all P＜0.05). The results of multivariate logistic regression analysis showed that elevated serum PLR, CRP/ALB, and NLR levels were independent risk factors for death in SAP patients (all P＜0.05). The results of the ROC curve analysis showed that, in predicting the death of SAP patients, the area under the curve of serum PLR, CRP/ALB, and NLR levels in combination (0.934) was larger than that of the three indicators alone (0.838, 0.823, 0.768, respectively). ConclusionIncreased serum PLR, CRP/ALB, and NLR levels are independent risk factors for poor prognosis (death) in SAP patients, and the clinical value of the three indicators in combination is quite high in predicting SAP patients′ prognosis.