2025 年第 2 期 第 20 卷

肝素结合蛋白和中性粒细胞/淋巴细胞比值及血小板/淋巴细胞比值对社区获得性肺炎患者预后的评估作用

Evaluation of the prognostic value of heparin-binding protein, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients with community-acquired pneumonia

作者：杨爱月1王青2

英文作者：Yang Aiyue1 Wang Qing2

单位：1浙江中医药大学附属温州中西医结合医院检验科，温州325000；2浙江省人民医院检验科，杭州310000

英文单位：1Department of Laboratory Medicine Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University Wenzhou 325000 China; 2Department of Laboratory Medicine Zhejiang Provincial People′s Hospital Hangzhou 310000 China

关键词：社区获得性肺炎；肝素结合蛋白；中性粒细胞；血小板

英文关键词：Community-acquiredpneumonia;Heparin-bindingprotein;Neutrophils;Bloodplatelets

• 摘要：

• 目的 探讨肝素结合蛋白、中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）对社区获得性肺炎（CAP）患者预后评估的价值。方法 选择2022年11月至2023年11月浙江中医药大学附属温州中西医结合医院收治的115例CAP患者作为观察对象。患者出院后进行28 d随访，根据生存情况将患者分为预后良好组（94例）和预后不良组（21例）。收集和比较2组患者一般资料和实验室指标。采用Logistic回归分析CAP患者预后不良的危险因素。采用受试者工作特征曲线分析肝素结合蛋白、NLR、PLR单独及联合评估CAP患者预后不良的价值。结果 2组性别、年龄、体重指数、吸烟史、饮酒史、糖尿病史、舒张压、收缩压、尿素氮、肌酐、丙氨酸转氨酶、天冬氨酸转氨酶水平比较差异均无统计学意义（均P＞0.05）。预后不良组临床肺部感染评分、白细胞介素6、C反应蛋白、降钙素原、白细胞计数、肝素结合蛋白、NLR、PLR均高于预后良好组，差异均有统计学意义（均P＜0.05）。多因素Logistic回归分析结果显示，临床肺部感染评分、白细胞介素6、C反应蛋白、降钙素原、白细胞计数、肝素结合蛋白、NLR、PLR均是CAP患者预后不良的危险因素（均P＜0.05）。受试者工作特征曲线分析结果显示，肝素结合蛋白、NLR、PLR评估CAP患者预后不良的曲线下面积分别为0.884、0.880、0.895，敏感度分别为0.714、0.762、0.810。三项联合评估CAP患者预后不良的曲线下面积为0.974，敏感度为0.905。结论 CAP预后不良患者的危险因素多且复杂，肝素结合蛋白、NLR、PLR等在CAP患者预后评估中均有较高价值。

• Objective To investigate the prognostic value of heparin-binding protein, neutrophil/lymphocyte ratio(NLR) and platelet/lymphocyte ratio(PLR) in patients with community-acquired pneumonia(CAP). Methods A total of 115 CAP patients admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University from November 2022 to November 2023 were selected as observation objects. The patients were followed up for 28 days after discharge. According to the survival situation, the patients were divided into good prognosis group (94 cases) and poor prognosis group (21 cases). The general data and laboratory indexes of the two groups were collected and compared. Logistic regression was used to analyze the risk factors of poor prognosis in CAP patients. The receiver operating characteristic curve was used to analyze the value of heparin-binding protein, NLR, PLR alone and the combination of other indicators in evaluating the poor prognosis of CAP patients. Results There were no significant differences in gender, age, body mass index, smoking history, drinking history, diabetes mellitus history, diastolic blood pressure, systolic blood pressure, urea nitrogen, creatinine, alanine aminotransferase, aspartate aminotransferase between the two groups (all P＞0.05). The clinical pulmonary infection score, interleukin-6, C-reactive protein, procalcitonin, white blood cell count, heparin-binding protein, NLR and PLR in the poor prognosis group were higher than those in the good prognosis group (all P＜0.05). Multivariate Logistic regression analysis showed that clinical pulmonary infection score, interleukin-6, C-reactive protein, procalcitonin, white blood cell count, heparin-binding protein, NLR and PLR were all risk factors for poor prognosis of CAP patients (all P＜0.05). The results of receiver operating characteristic curve analysis showed that the area under the curve of heparin-binding protein, NLR, and PLR for evaluating the poor prognosis of CAP patients was 0.884, 0.880, and 0.895, respectively, and the sensitivity was 0.714, 0.762, and 0.810, respectively. The area under the curve of the three factors combined to evaluate the poor prognosis of CAP patients was 0.974, and the sensitivity was 0.905. Conclusion There are many and complex risk factors for poor prognosis of CAP patients. Heparin-binding protein, NLR and PLR have high value in the prognosis evaluation of CAP patients.