许中, 陈影, 陈敏, 马丽, 周伟君, 毛恩强, 陈尔真. 白细胞与血小板比值评估社区获得性肺炎早期预后的临床研究J. 职业卫生与应急救援, 2025, 43(6): 736-741. DOI: 10.16369/j.oher.issn.1007-1326.2025.250209
引用本文: 许中, 陈影, 陈敏, 马丽, 周伟君, 毛恩强, 陈尔真. 白细胞与血小板比值评估社区获得性肺炎早期预后的临床研究J. 职业卫生与应急救援, 2025, 43(6): 736-741. DOI: 10.16369/j.oher.issn.1007-1326.2025.250209
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XU Zhong, CHEN Ying, CHEN Min, MA Li, ZHOU Weijun, MAO Enqiang, CHEN Erzhen. Clinical study on white blood cell to platelet ratio in assessing the early prognosis of community-acquired pneumoniaJ. Occupational Health and Emergency Rescue, 2025, 43(6): 736-741. DOI: 10.16369/j.oher.issn.1007-1326.2025.250209
Citation: XU Zhong, CHEN Ying, CHEN Min, MA Li, ZHOU Weijun, MAO Enqiang, CHEN Erzhen. Clinical study on white blood cell to platelet ratio in assessing the early prognosis of community-acquired pneumoniaJ. Occupational Health and Emergency Rescue, 2025, 43(6): 736-741. DOI: 10.16369/j.oher.issn.1007-1326.2025.250209
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白细胞与血小板比值评估社区获得性肺炎早期预后的临床研究

Clinical study on white blood cell to platelet ratio in assessing the early prognosis of community-acquired pneumonia

    摘要
  • 摘要:
    目的 探讨白细胞与血小板比值（WBC/PLT值）对急诊社区获得性肺炎（CAP）早期预后评估的临床价值。
    方法 纳入2023年1月—2024年12月期间于上海交通大学医学院附属瑞金医院急诊科就诊的128例社区获得性肺炎（CAP）患者，对其临床资料进行回顾性分析。存活组患者107例，死亡组21例，比较两组患者发病后24 h内的WBC/PLT值及临床生化指标的差异。采用logistic回归模型分析影响CAP患者预后的危险因素；绘制受试者操作特征曲线（ROC曲线），以ROC曲线下面积（AUC）评价各项指标对患者死亡风险的预测价值。
    结果 128例CAP患者平均年龄为（72.45 ± 17.12）岁。死亡组合并脓毒症、呼吸衰竭和使用血管活性药物的人数占比均高于存活组（P < 0.05）；死亡组CAP患者白细胞计数、尿素氮和肌酐值以及CURB-65评分高于存活组，血小板计数低于存活组（均P < 0.05）。死亡组WBC/PLT中位值为0.10（0.09，0.15），高于存活组的0.03（0.02，0.04），差异有统计学意义（P < 0.05）。多因素logistic回归分析结果显示：WBC/PLT值每增加1个单位，患者死亡的风险增加至原来的1.520倍；年龄每增加1岁，死亡的风险增加至原来的1.178倍；氧合指数每增加一个单位，死亡的风险降低到原来的0.954倍（均P < 0.05）。ROC曲线分析结果显示，WBC/PLT值在预测CAP患者预后的曲线下面积（AUC）为0.962（P < 0.001），当约登指数为0.878时，该指标的灵敏度为95.2%，特异度为92.5%。
    结论 WBC/PLT值与CAP患者预后有一定相关性，对早期筛查高危患者具有一定的指导意义。

     

    Abstract:
    Objective To investigate the clinical value of the white blood cell to platelet ratio (WBC/PLT) in assessing the early prognosis of patients with community-acquired pneumonia (CAP) in the emergency department.
    Methods A total of 128 patients with CAP admitted to the Emergency Department of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from January 2023 to December 2024, were studied retrospectively. Patients were divided into a survival group (n=107) and a non-survival group (n=21). Differences in the WBC/PLT ratio and other clinical biochemical indicators within 24 hours of admission were compared. A logistic regression model was employed to analyze risk factors associated with mortality. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC) was used to evaluate the predictive value of various indicators for mortality.
    Results The mean age of the 128 CAP patients was (72.45 ± 17.12) years. The non-survival group had a significantly higher proportion of patients with sepsis, respiratory failure, and use of vasoactive drugs (P < 0.05). Compared to patients in the survival group, the patients in the non-survival group had significantly higher white blood cell counts, urea nitrogen, creatinine levels, and CURB-65 scores, and significantly lower platelet counts (all P < 0.05). The median WBC/PLT ratio in the non-survival group was 0.10 (0.09, 0.15), significantly higher than the 0.03(0.02, 0.04) in the survival group (P < 0.05). Multivariate logistic regression analysis revealed that for each unit increase in WBC/PLT ratio, the risk of patient mortality increased to 1.520 times the baseline; for each additional year of age, mortality risk increased to 1.178 times the baseline; and for each unit increase in oxygenation index, mortality risk decreased to 0.954 times the baseline (all P < 0.05). ROC curve analysis demonstrated that the AUC of the WBC/PLT ratio in predicting mortality was 0.962 (P < 0.001). At the optimal Youden index (0.878), the sensitivity was 95.2% and the specificity was 92.5%.
    Conclusions The WBC/PLT ratio was significantly associated with the prognosis of CAP patients and may serve as a guiding significance for the early identification of high-risk patients.

     

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