Correlation of neutrophil-to-lymphocyte ratio and serum interleukin-6 level with severity and prognosis of severe pneumonia in patients
10.3760/cma.j.cn341190-20240427-00472
- VernacularTitle:NLR和血清IL-6水平与重症肺炎患者病情严重程度及预后的关系
- Author:
Han WU
1
;
Ling CHEN
;
Xiaogang HU
Author Information
1. 丽水市第二人民医院呼吸与危重症医学科，丽水 323000
- Keywords:
Pneumonia;
Intensive care units;
Interleukin-6;
Lymphocytes;
Patient acuity;
Logistic models;
ROC curve
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(11):1612-1618
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To correlate neutrophil/lymphocyte ratio (NLR) and serum interleukin-6 (IL-6) level with severity and prognosis of severe pneumonia in patients.Methods:The clinical data of 158 patients with severe pneumonia who received treatment in the Intensive Care Unit of The Second People's Hospital of Lishui from January 2021 to June 2023 were retrospectively analyzed. These 158 patients constituted the case group. Based on their Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores at admission, the patients were categorized into low-risk ( n = 67), medium-risk ( n = 52), and high-risk ( n = 39) groups. Additionally, they were further divided into a survival group ( n = 125) and a death group ( n = 33) according to their survival status at 28 days post-admission. Fifty-one healthy individuals who underwent physical examinations at the same hospital during the same period were included in the control group. The NLR and IL-6 levels were compared among the groups. Pearson correlation analysis was conducted to analyze the correlation of NLR and IL-6 levels with the APACHE Ⅱ score. Multivariate Cox regression analysis was performed to evaluate the effects of NLR and IL-6 levels on the prognosis of severe pneumonia. A logistic regression model was developed to create a prediction model for the prognosis of these patients based on NLR and IL-6 levels. Receiver operating characteristic curves were generated to assess the area under the curve (AUC), sensitivity, and specificity of NLR, IL-6, and their combination in predicting the prognosis of patients with severe pneumonia. Results:In the case group, the NLR and IL-6 levels were (8.38 ± 5.16) and (116.08 ± 45.95) ng/L, respectively, both of which were significantly higher than those in the control group [(1.06 ± 0.35), (41.25 ± 10.05) ng/L, t = 10.11, 11.52, both P < 0.001]. In the high-risk group, the NLR, IL-6, and APACHE Ⅱ scores were (15.52 ± 4.69), (159.74 ± 58.63) ng/L, and (26.88 ± 5.47) points, respectively, all of which were significantly higher than those in the low-risk group [(4.62 ± 1.08), (86.45 ± 14.47) ng/L, (7.58 ± 1.45) points, thigh-risk groupvs. low-risk group = 16.22, 8.68, 24.37, all P < 0.05] and medium-risk group [(7.86 ± 2.47), (121.52 ± 32.05) ng/L, (16.85 ± 3.14) points, thigh-risk groupvs. medium-risk group = 10.07, 3.98, 11.03, all P < 0.05]. Pearson correlation analysis indicated that both NLR and IL-6 were positively correlated with the APACHE Ⅱ score ( r = 0.827, 0.873, both P < 0.05). In the death group, the NLR and IL-6 levels were (11.83 ± 6.39) and (144.68 ± 64.62) ng/L, respectively, which were significantly higher than those in the survival group [(7.46 ± 4.37), (108.53 ± 36.34) ng/L, t = 4.60, 4.23, both P < 0.05]. Multivariate Cox regression analysis demonstrated that elevated levels of NLR and IL-6 were significant risk factors affecting the prognosis of patients with severe pneumonia (both P < 0.05). Receiver operating characteristic curve analysis revealed that the AUC for NLR, IL-6, and their combination in predicting the prognosis of severe pneumonia patients were 0.702, 0.664, and 0.881, respectively. The AUC for the combination was significantly greater than that for NLR or IL-6 alone ( Z = 2.77, 3.15, both P < 0.05). Conclusion:NLR and IL-6 levels are abnormally elevated in patients with severe pneumonia, and their levels change with the severity of the disease and affect the prognosis of patients.
