| 刘先,梁晓林,蒲忠信.中性粒细胞与淋巴细胞数比值用于急诊疑似感染伴快速序贯器官衰竭评估 =1病人的预后评估[J].安徽医药,2026,30(9):1869-1874. |
| 中性粒细胞与淋巴细胞数比值用于急诊疑似感染伴快速序贯器官衰竭评估 =1病人的预后评估 |
| Prognostic value of neutrophil-to-lymphocyte ratio in emergency patients with suspected infection and a quick sequential organ failure assessment score of 1 |
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| DOI：10.3969/j.issn.1009-6469.2026.09.032 |
| 中文关键词: 感染 急诊 序贯器官衰竭评估 中性粒细胞 淋巴细胞 |
| 英文关键词: Infection Emergency Sequential organ failure assessment Neutrophil Lymphocyte |
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| 中文摘要: |
| 目的探讨中性粒细胞与淋巴细胞数比值( NLR)用于急诊疑似感染伴快速序贯器官衰竭评估( qSOFA)=1病人的预后评估的可行性。方法回顾性研究。从 MIMIC-Ⅳ数据库纳入 2008—2018年急诊疑似感染伴 qSOFA=1的病人，分为 A组(意识形态改变)、 B组［收缩压 ≤100 mmHg(1 mmHg=0.133 kPa)］、C组(呼吸频率 ≥22次/分)，比较高 NLR与低 NLR病人的不良预后的风险差异。主要不良预后为 28 d死亡，次要不良预后为 72 h接受重症技术支持，包括使用有创呼吸机、使用血管升压药及行肾脏替代治疗( RRT)。结果纳入病人 3 712例， A组 942例， B组 1 216例， C组 1 554例。 B组 NLR为 8.0(4.0，15.0)。 logistic回归分析表明， B组 NLR是 28 d死亡的独立影响因素( OR=1.02，P<0.001)； A、C组 NLR非 28 d死亡的独立影响因素( P>0.05)。 Cox比例风险回归分析表明， B组 NLR≥15的死亡风险高于 NLR<15者( HR=1.68，P=0.015)； NLR≥4与 NLR<4之间死亡风险差异无统计学意义( P>0.05)。 B组在院时间 ≥72 h病人中 NLR≥15的 72 h接受重症技术支持者的风险高于 NLR<15者(使用有创呼吸机 HR=1.82，P=0.005；使用血管升压药 HR=1.91，P<0.001；行 RRT HR=2.38，P=0.013)。结论 NLR可能适用于急诊疑似感染伴 qSOFA=1(收缩压 ≤100 mmHg)病人的预后评估。 |
| 英文摘要: |
| Objective To explore the application of the neutrophil-to-lymphocyte ratio (NLR) in the prognostic evaluation of emergen.cy patients with suspected infection and a quick sequential organ failure assessment (qSOFA) score of 1. Methods A retrospectivestudy was conducted. Patients with suspected infection and a qSOFA score of 1 in the emergency department from 2008 to 2018 wereincluded from the MIMIC -Ⅳ database. They were divided into Group A (altered mental status), Group B [systolic blood pressure ≤100mmHg (1 mmHg=0.133 kPa)], and Group C (respiratory rate ≥22 breaths per minute). The differences in the risk of adverse outcomesbetween patients with high NLR and low NLR were compared. The primary adverse outcome was 28 -day mortality, and the secondaryadverse outcome was the need for intensive care technology support within 72 hours, including the use of invasive ventilators, vasopres. sors, and renal replacement therapy (RRT).Results A total of 3 712 patients were included, with 942 in Group A, 1 216 in Group B,and 1 554 in Group C. The NLR in Group B was 8.0 (4.0, 15.0). Logistic regression analysis showed that NLR in Group B was an inde.pendent influencing factor for 28 -day mortality (OR=1.02, P<0.001); NLR in Groups A and C was not an independent influencing fac. tor for 28 -day mortality (P>0.05). Cox proportional -hazards regression analysis indicated that the mortality risk of patients with NLR≥15 in Group B was higher than that of those with NLR<15 (HR=1.68, P=0.015); there was no statistically significant difference in the mortality risk between patients with NLR≥4 and those with NLR<4 (P>0.05). Among patients with a hospital stay of≥72 hours in GroupB, the risk of receiving intensive care technology support within 72 hours was higher in patients with NLR≥15 than in those with NLR<15 (invasive mechanical ventilator use: HR=1.82, P=0.005; vasopressor use: HR=1.91, P<0.001; RRT: HR=2.38, P=0.013). Conclu. sion NLR may be applicable for the prognostic evaluation of emergency patients with suspected infection and a qSOFA score of 1(systolic blood pressure ≤100 mmHg). |
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