检验医学与临床2025，Vol.22Issue(17)：2327-2334,8.DOI:10.3969/j.issn.1672-9455.2025.17.005
基于NLR、PCT、H-FABP构建老年社区获得性肺炎患者发生心血管事件的预测模型
A predictive model for cardiovascular events in elderly patients with community-acquired pneumonia was constructed based on NLR,PCT and H-FABP
摘要
Abstract
Objective To construct a predictive model for cardiovascular events(CVE)in elderly patients with community-acquired pneumonia(CAP)based on the levels of neutrophil to lymphocyte ratio(NLR),procalcitonin(PCT)and heart-type fatty acid binding protein(H-FABP).Methods A total of 260 elderly CAP patients admitted to the hospital from January 2021 to January 2023 were selected as the research sub-jects.Patients were divided into CVE group and non-CVE group according to whether CVE occurred during hospitalization.Clinical data of elderly CAP patients were collected,NLR was calculated,and the levels of PCT and H-FABP were detected by enzyme-linked immunosorbent assay.LASSO regression was used to screen the factors affecting the occurrence of CVE in elderly CAP patients.The non-zero characteristic variables were subjected to multivariate unconditional Logistic regression analysis to determine the independent risk factors for CVE in elderly CAP patients.R language was used to construct the prediction model of CVE in elderly CAP patients based on NLR,PCT and H-FABP.C-index,calibration curve,decision curve and Hosmer-Leme-show test were used for internal verification.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of the prediction model for CVE in elderly CAP patients based on NLR,PCT and H-FABP.Results CVE group included 179 patients,and non-CVE group included 81 patients,with incidence of CVE of 68.85％(179/260).The age and proportions of patients with long-term bed rest,aspiration pneu-monia,hypertension,coronary heart disease,chronic heart failure,cerebrovascular disease,altered conscious-ness,pleural effusion,as well as CURB-65 score,pneumonia severity index(PSI)score,respiratory rate,blood urea nitrogen level,lactic acid level,albumin level,NLR,PCT level,H-FABP level were compared between the two groups,the differences were statistically significant(P＜0.05).LASSO regression screened 8 variables with nonzero characteristics(λ=0.006 778 715),which were age,hypertension,coronary heart disease,chronic heart failure,PSI,NLR,PCT,H-FABP.Multivariate unconditional Logistic regression analysis showed that ol-der age,coronary heart disease,chronic heart failure,high PSI score,elevated NLR,elevated PCT and elevated H-FABP were independent risk factors for CVE in elderly CAP patients(P＜0.05).The prediction model for CVE in elderly CAP patients based on NLR,PCT and H-FABP has a high consistency with the actual risk of CVE in elderly CAP patients.ROC curve analysis showed that when the maximum Youden index was 0.671,the area under the curve of the prediction model for predicting CVE in elderly CAP patients was 0.901(95％CI:0.858-0.934),and the sensitivity and specificity were 78.21％and 88.89％respectively.Conclusion Elevated NLR,PCT and H-FABP levels are risk factors for CVE in elderly CAP patients.The prediction mod-el for CVE in elderly CAP patients based on NLR,PCT and H-FABP has a high predictive efficiency.关键词
老年社区获得性肺炎/中性粒细胞与淋巴细胞比值/降钙素原/心型脂肪酸结合蛋白/心血管事件/预测模型Key words
elderly patients with community-acquired pneumonia/neutrophil to lymphocyte ratio/pro-calcitonin/heart-type fatty acid-binding protein/cardiovascular event/prediction model分类
医药卫生引用本文复制引用
闫竹梅,赵琴,冯辽辽..基于NLR、PCT、H-FABP构建老年社区获得性肺炎患者发生心血管事件的预测模型[J].检验医学与临床,2025,22(17):2327-2334,8.基金项目
陕西省科技计划项目(2020JM1073). （2020JM1073）
