| 潘瑞,王滔,王兆,等.中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值早期预测重症急性胰腺炎病情进展的应用价值分析[J].安徽医药,2025,29(1):105-109. |
| 中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值早期预测重症急性胰腺炎病情进展的应用价值分析 |
| The early predictive value of NLR and PLR for the severity and prognosis of severe acute pancreatitis |
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| DOI：10.3969/j.issn.1009-6469.2025.01.021 |
| 中文关键词: 胰腺炎，急性坏死性 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 预测 预后 |
| 英文关键词: Pancreatitis, acute necrotizing Neutrophil to lymphocyte ratio Platelet to lymphocyte ratio Forecast Prognosis |
| 基金项目:贵州省卫生健康委科学技术基金自主项目( zywjkj2019-1-070) |
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| 中文摘要: |
| 目的探讨中性粒细胞与淋巴细胞比值( NLR)、血小板与淋巴细胞比值( PLR)对重症急性胰腺炎及转归的早期预测的临床应用价值。方法回顾性收集遵义市第一人民医院 2018年 1月 1日至 2023年 3月 1日连续收治的 290例初治急性胰腺炎病人的临床资料，包括病人一般临床资料和血常规各项指标(入院 24 h内)及重症急性胰腺炎(SAP)病人临床诊疗与预后指标等。将病人分为 SAP组( 105例)与非 SAP组( 185例)分析比较两组各项指标的差异，并绘制受试者操作特征曲线( ROC曲线)寻找最佳诊断值；然后将 SAP组分为 NLR和 PLR升高组，(45例)与非升高组( 60例)分析比较其临床转归及预后情况。结果两组病人基线平齐，差异无统计学意义( P>0.05)； SAP病人急性生理学和慢性健康状况，评价 Ⅱ(APACHE Ⅱ)评分和 Ranson评分更高［ 6(5，8)分比 17(14，20)分， 1(1，2)分比 4(3，4)分，均 P<0.001］，NLR和 PLR在 SAP病人中均更高( P<0.05)。 ROC曲线分析显示 NLR和 PLR最佳诊断值分别为 6.58，157.89。SAP病人中， NLR和 PLR升高与非升高病人相比，升高组住院时间更长(P=0.003)、禁食时间更长( P<0.001)、引流管数量更多(P<0.001)、住院费用更高( P=0.002)、死亡率更高( P=0.047)。结论 NLR和 PLR升高对 SAP早期具有诊断与预后预测价值，警惕非 SAP病人病情迅速进展为 SAP；对于 SAP病人， NLR和 PLR升高提示病人病情危重，转归与预后不佳。 |
| 英文摘要: |
| Objective To explore the early predictive significance of the neutrophil to lymphocyte ratio (NLR) and platelet to lympho-cyte ratio (PLR) for assessing the severity and prognosis of severe acute pancreatitis (SAP). Methods A retrospective analysis was con-ducted on clinical data from 290 patients receiving initial treatment for acute pancreatitis at the First People's Hospital of Zunyi Cityfrom January 2018 and March 2023. The patients were categorized into the SAP group (n=105) and the non-SAP group (n=185). The clin-ical data and biochemical markers between the two groups were compared. The ROC curve was used to analyze the predictive perfor-mance of NLR and PLR for SAP. Then SAP patients were assigned into NLR and PLR elevated group (n=45) and non-elevated group (n= 60), and the clinical and prognostic data were compared. Results The baseline data was comparable. Acute physiology and chronichealth evaluation Ⅱ (APACHEⅡ) and Ranson were higher in SAP patients [6 (5, 8) points vs. 17 (14, 20) points, 1 (1, 2) points vs. 4 (3, 4) points, P<0.001]. NLR and PLR were significantly higher in the SAP group (P<0.05). ROC curve analysis results showed that the cut-off value was 6.58 and 157.89, respectively. In SAP patients, NLR and PLR elevated group had disadvantages in hospital stay (P= 0.003), abrosia time (P<0.001), drainage tube (P<0.001), hospitalization expenses (P=0.002) and mortality rate (P=0.047). Conclu. sions The increase of NLR and PLR is valuable in the early diagnosis and prognosis of SAP, and the rapid progression to SAP in non-SAP patients should be warned. Elevated NLR and PLR indicate critical illness, poor outcome and prognosis of SAP patients. |
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