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A2DS2评分联合中性粒细胞与淋巴细胞比值对急性缺血性卒中相关性肺炎的预测价值

A2DS2 combined with neutrophil-to-lymphocyte ratio in the prediction of acute ischemic stroke-associated pneumonia

    摘要
  • 摘要:
    目的 探讨A2DS2评分联合中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio，NLR)对卒中相关性肺炎(stroke associated pneumonia，SAP)的预测价值。
    方法 回顾性收集2018年1月至2018年8月上海交通大学附属第六人民医院收治的468例急性缺血性脑卒中患者的病例资料，根据是否合并SAP分为SAP组(61例)和非SAP组(407例)。对所有患者进行A2DS2评分并计算NLR值。采用受试者工作特征曲线(receiver operating curve，ROC)评估A2DS2-NLR评分对SAP的预测价值。
    结果 A2DS2评分的曲线下面积(area under curve，AUC)为0.868(95% CI 0.815~0.921)，灵敏度为0.787，特异度为0.803，最佳截断值为3.5。A2DS2-NLR模型1(NLR>3.73时加1分)的AUC为0.888(95% CI 0.844~0.932)，灵敏度为0.803，特异度为0.789，最佳截断值为3.5；A2DS2-NLR模型2(NLR>3.73时加2分)评分的AUC为0.892(95% CI 0.850~0.935)，灵敏度为0.852，特异度为0.754，最佳截断值为3.5。
    结论 与A2DS2评分相比，A2DS2-NLR模型1评分在预测SAP风险方面价值更高。

     

    Abstract:
    Objective To explore predictive effect of the A2DS2 scoring system combined with neutrophil-to-lymphocyte ratio (NLR) on stroke-associated pneumonia (SAP).
    Methods Data of 468 patients with acute ischemic stroke admitted to the Sixth People's Hospital, Shanghai Jiao Tong University from January 2018 to August 2018 were retrospectively collected, patients were divided into SAP group (n=61) and non-SAP group (n=407). A2DS2 score and NLR value were calculated for all patients. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of A2DS2-NLR score to SAP.
    Results The area under curve (AUC) of A2DS2 score was 0.868 (95% CI 0.815-0.921), the sensitivity was 0.787, the specificity was 0.803, and the optimal cut-off value was 3.5. The AUC of A2DS2-NLR model 1 score (NLR>3.73, +1) was 0.888 (95% CI 0.844-0.932), the sensitivity was 0.803, the specificity was 0.789, and the optimal cut-off value was 3.5. The AUC of A2DS2-NLR model 2 score (NLR>3.73, +2) was 0.892 (95% CI 0.850-0.935), the sensitivity was 0.852, the specificity was 0.754, and the optimal cut-off value was 3.5.
    Conclusions Compared to the A2DS2 score, the A2DS2-NLR model 1 score has higher value in predicting the risk of SAP.

     

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