摘要目的:探讨C反应蛋白（C-reactive protein, CRP）、中性粒细胞计数和淋巴细胞计数比（neutrophils-lymphocytes ratio, NLR）和白细胞计数和红细胞计数比（leukocyte-erythrocyte ratio, LER）对急性脑梗死（acute cerebral infarction, ACI）患者发生吸入性肺炎（aspiration pneumonia, AP）的预测价值。方法:回顾性分析2021年度连续住院的发病48 h内且无感染的ACI患者989例。采集患者一般资料、既往病史、入院24 h内的CRP和血常规，并根据中性粒细胞计数、淋巴细胞计数、白细胞计数和红细胞计数计算NLR和LER。根据ACI患者入院48 h后是否并发AP，将患者分为Non-AP组883例和AP组106例。Spearman相关分析CRP、NLR和LER与AP的相关性；绘制受试者工作特征（receiver operator characteristic, ROC）曲线，评估CRP、NLR和LER对ACI患者发生AP的预测价值，并计算最佳截断值时的敏感度和特异度。采用Logistic回归进一步验证。结果:与Non-AP组比较，AP组CRP、NLR和LER明显增高（ P<0.05）。Spearman相关分析显示，AP与CRP、NLR和LER呈正相关（ r=0.42、0.36和0.35, P<0.01）。ROC曲线分析显示，CRP、NLR和LER对ACI患者发生AP均有一定预测价值（ P<0.05），曲线下面积（Area Under Curve，AUC）分别为0.8917、0.8349和0.8269。三者最佳截断值分别为12.70 mg/L、4.40和1.89 ×10 -3，此时的敏感度和特异度分别为79.25%和86.41%、71.70%和84.94%以及75.47%和79.95%。经多因素Logistic回归分析结果显示，CRP（ OR=6.65，95% CI: 3.70~11.98， β=1.90, P<0.001）、NLR（ OR=2.84，95% CI: 1.60~5.03， β=1.04, P<0.001））和LER（ OR=3.51，95% CI: 2.00~6.16， β=1.26, P<0.001））均为ACI患者发生AP的独立危险因素。 结论:基线CRP、NLR和LER三者均对ACI患者发生AP具有一定预测价值，其中CRP预测能力最强。

abstractsObjective:To investigate the predictive value of C-reactive protein (CRP), neutrophils-lymphocytes ratio (NLR) and leukocyte-erythrocyte ratio (LER) for aspiration pneumonia (AP) in patients with acute cerebral infarction (ACI).Methods:Retrospective analysis was performed on 989 consecutive hospitalized ACI patients in 2021 who were free of infection within 48 h after ACI onset. General information, past medical history, CRP and complete blood count within 24 h after admission were collected. NLR and LER were calculated based on neutrophil, lymphocyte, leukocyte and erythrocyte count. ACI patients were divided into two groups: non-AP group ( n = 883) and AP group ( n = 106) according to whether they had AP 48 h after admission. Spearman correlations of CRP, NLR and LER with AP were analyzed. The receiver operator characteristic (ROC) curves were plotted to evaluate the predictive values of CRP, NLR and LER for the occurrence of AP in ACI patients, and the sensitivity and specificity at the optimal cut-off value were also calculated. Logistic regression analysis was used for further verification. Results:Compared with the non-AP group, CRP, NLR and LER were significantly higher in the AP group ( P<0.05). Spearman correlation analysis showed that AP was positively correlated with CRP, NLR and LER ( r = 0.42, 0.36 and 0.35, P<0.01). ROC curve analysis showed that CRP, NLR and LER had certain predictive value for AP in ACI patients ( P<0.05), and the area under the curve (AUC) was 0.8917, 0.8349 and 0.8269, respectively. The optimal cutoff values of CRP, NLR and LER were 12.70 mg/L, 4.40 and 1.89 ×10 -3, respectively, with the sensitivity and specificity of 79.25% and 86.41%, 71.70% and 84.94%, and 75.47% and 79.95%, respectively. Multivariate Logistic regression analysis showed that CRP ( OR=6.65, 95% CI: 3.70-11.98, β=1.90, P<0.001), NLR ( OR=2.84,95% CI: 1.60-5.03, β=1.04, P<0.001) and LER ( OR=3.51, 95% CI: 2.00-6.16, β=1.26, P<0.001) were independent risk factors for AP in ACI patients. Conclusions:CRP, NLR and LER at baseline show certain predictive value for the occurrence of AP in ACI patients, and CRP has the strongest predictive power.