中性粒细胞与淋巴细胞比值在急性胰腺炎并发急性肾损伤患者病情诊断中的价值  

The diagnostic value of neutrophil-to-lymphocyte rate （NLR） in acute pancreatitis related acute kidney injury patients

作　　者：邵国建 王雷[2] 刘琦[2] 张浩[3] 潘达[3] 张一帆 刘洋[3] 

机构地区：[1]温州市中心医院肾脏内科,浙江温州325000 [2]第二军医大学长海医院消化内科 [3]第二军医大学学员旅

出　　处：《中华胰腺病杂志》2016年第3期181-184,共4页Chinese Journal of Pancreatology

基　　金：温州市科技局科研基金（Y20140287）;第二军医大学大学生创新基金（FH2014077）

摘　　要：目的：探讨中性粒细胞与淋巴细胞比值（ NLR ）在急性胰腺炎（ AP ）并发急性肾损伤（ AKI）患者中与病程进展及肾功能损伤程度之间的关系，评估其对AKI的诊断价值。方法回顾性分析温州市中心医院2013年1月至2014年6月收治的98例确诊为AP患者的临床资料，按是否发生AKI分为并发AKI组和未并发AKI组，将NLR≥3．1归入高NLR组，＜3．1归入低NLR组。观察患者就诊初始NLR、体重指数（ BMI ）、血细胞比容（ Hct ）、谷丙转氨酶（ ALT ）、总胆固醇（ TC ）、三酰甘油（TG）、血钙、肌酐（Scr）、尿素氮（BUN）、APACHEⅡ评分及C反应蛋白（CRP）等指标的变化，分析上述指标之间的相关性。结果 AP并发AKI组和未并发AKI组患者的年龄、BMI、Hct、TG、TC、ALT、血钙等的差异均无统计学意义。 AP并发AKI组患者的血Scr、BUN、CRP、APACHEⅡ评分分别为（395±122）μmol／L、（28．2±5．2） mmol／L、（34．0±8．2） mg／L、（11．5±3．8）分，未并发 AKI 组分别为（79±17）μmol／L、（7．3±2．0）mmol／L、（14．8±2．9）mg／L、（6．9±2．4）分，并发AKI组显著高于未并发AKI组，差异均有统计学意义（P值均＜0．01）。高NLR组和低NLR组患者的年龄、BMI、Hct、TG、TC、血钙的差异均无统计学意义。高 NLR 组患者的血 ALT、Scr、BUN、CRP、APACHEⅡ评分分别为（257±76） U／L、（159±62）μmol／L、（20．5±6．6）mmol／L、（24．8±5．5）mg／L、（12．4±4．6）分，低NLR组为（165±30）U／L、（98±23）μmol／L、（14．3±5．2）mmol／L、（19．5±3．0）mg／L、（5．4±2．1）分，两组间差异均有统计学意义（P值均＜0．05）。 AP并发AKI组患者的NLR为4．97±0．19，中位数为4．60；AP未并发AKI组患者NLR为9．62±0．81，中位数为8．90，两组间差异具有统计学意义（P＝0．0001）。 NLR诊断AP并发AKI的受试者工作特征（ROC）曲线�Objective To investigate the diagnostic and prognostic value of neutrophil-to-lymphocyte rate （ NLR） in acute pancreatitis related acute kidney injury patients .Methods Peripheral blood specimens and clinical information of 98 acute pancreatitis patients in Wenzhou Center Hospital were collected .The WBC, neutrophils , lymphocytes were detected and NLR were calculated when they were admitted .The patients were divided into two groups by their NLR and whether they were with AKI respectively .Besides, ALT, Hct, TC, TG, blood calcium concentration , serum creatine and urea nitrogen , C reactive protein were detected and＆amp;nbsp;patients′APACHEⅡ score were also recorded to analyze the difference between the two groups .Results There is no significance in the age , BMI, Hct, TG, TC, ALT and blood calcium between AP patients with and without AKI.The blood creatinine, BUN, CRP, APACHEⅡscore were （395 ±122）μmol/L, （28.2 ±5.2） mmol/L, （34.0 ±8.2）mg/L, （11.5 ±3.8） score, respectively in AP patients with AKI, and which were （79 ±17 ）μmol/L, （ 7.3 ±2.0 ） mmol/L, （ 14.8 ±2.9 ） mg/L, （ 6.9 ±2.4 ） score, respectively in AP patients without AKI.The blood ALT, blood creatinine, BUN, CRP, APACHEⅡscore were （257 ±76）U/L, （159 ±62）μmol/L, （20.5 ±6.6）mmol/L, （24.8 ±5.5）mg/L and （12.4 ±4.6） score in the patients with higher NLR respectively , and which were （ 165 ±30 ） U/L, （ 98 ±23 ）μmol/L, （ 14.3 ±5.2 ） mmol/L, （19.5 ±3.0）mg/L and （5.4 ±2.1） score in the patients with lower NLR respectively .NLR was 4.97 ±0.19 in AP patients with AKI, and was 9.62 ±0.81 in AP patients without AKI.The difference between the two groups was significant（P=0.0001）.The area under ROC curve of diagnosing AP by NLR was 0.895 （95%CI 5.75）.the sensitivity was 89.5%and the specificity was 77.2% when using 5.75 as the cut-off value to diagnose AP related AKI with NLR .Conclusions NLR can be a potential predictive index of the severity and relat

关 键 词：胰腺炎 急性肾功能不全 中性粒细胞与淋巴细胞比值 

分 类 号：R576[医药卫生—消化系统] R692[医药卫生—内科学]