【摘要】 目的 分析降钙素原（PCT）、PCT/白蛋白（ALB）及外周血中性粒细胞/淋巴细胞比值（NLR）水平评估尿毒症维持性血液透析（MHD）患者并发肺部感染的临床价值分析。方法 选取芜湖市中医医院2022年1月至2025年3月期间尿毒症并行MHD治疗≥3个月的患者93例为研究对象，根据是否并发肺部感染分为感染组、非感染组，比较感染组与非感染组及感染组不同感染严重程度患者PCT、PCT/ALB及NLR水平，采用Logistic回归分析并发肺部感染的独立影响因素，采用受试者工作特征曲线（ROC）评估指标对并发肺部感染的预测效能。结果 感染组PCT、PCT/ALB及NLR水平均高于非感染组，差异有统计学意义（P<0.05），且重度感染者PCT、PCT/ALB及NLR水平均分别高于轻度、中度感染，差异有统计学意义（P<0.05）;Logistic回归分析显示，PCT升高（OR=3.983）、PCT/ALB升高（OR=5.596）及NLR升高（OR=2.547）是尿毒症MHD患者并发肺部感染的独立危险因素（P<0.05）;ROC曲线显示，PCT/ALB对肺部感染的诊断效能最高（AUC=0.780,95%CI:684～0.877）,PCT/ALB联合PCT、NLR预测肺部感染的AUC提升至0.812，敏感度和特异度分别为0.833、0.727。结论 PCT、PCT/ALB及NLR与尿毒症MHD患者并发肺部感染的发生及感染严重程度密切相关，联合检测对肺部感染具有一定的早期预测价值。更多还原

【Abstract】 Objective To analyze the clinical value of procalcitonin(PCT), PCT/albumin(ALB) and peripheral blood neutrophil/lymphocyte ratio(NLR) on evaluating pulmonary infection in uremic patients with maintenance hemodialysis(MHD). Methods A total of 93 patients with uremia who were underwent MHD for more than 3 months from January 2022 to March 2025 at Wuhu Hospital of Traditional Chinese Medicine were selected as research subjects. They were divided into two groups based on whether thay had pulmonary infection: an infection group and a non-infection group. The levels of PCT, PCT/ALB, and NLR were compared between the infection and non-infection groups, as well as among patients with varying degrees of infection severity within the infection group. Logistic regression analysis was used to identify independent factors influencing pulmonary infection. Receiver operating characteristic curve(ROC) analysis was used to assess the predictive accuracy of these indicators for pulmonary infection. Results The levels of PCT, PCT/ALB, and NLR in the infection group were higher than those in the non-infection group, with statistical significance(P<0.05). These levels were found to be higher in patients with severe infections compared to those with mild or moderate infections, with statistical significance(P<0.05). Logistic regression analysis showed that elevated PCT(OR=3.983), elevated PCT/ALB(OR=5.596), and elevated NLR(OR=2.547) were independent risk factors for pulmonary infection in uremic MHD patients(P<0.05). Furthermore, ROC analysis showed that PCT/ALB had the highest diagnostic efficiency for pulmonary infection(AUC=0.780, 95%CI: 684-0.877). The AUC of PCT/ALB combined with PCT and NLR in predicting pulmonary infection increased to 0.812, with a sensitivity of 0.833 and a specificity of 0.727. Conclusion PCT, PCT/ALB, and NLR are closely related to the occurrence and severity of pulmonary infections in uremic MHD patients. Combined detection has a certain early predictive value for pulmonary infection.更多还原