早期血小板和淋巴细胞比值在老年ICU重症感染患者中的应用价值  

Application Value of Early Platelet/lymphocyte Ratio for Elderly Patients with Severe Infection in ICU

作　　者：金凯[1] 俞瑞东[1] 吴志雄[1] 陆小川[1] 韩冰[1] 宋晓华[1] Jin Kai;Yu Ruidong;Wu Zhixiong(SICU,East China Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华东医院,上海200040

出　　处：《医学研究杂志》2019年第1期147-151,共5页Journal of Medical Research

摘　　要：目的研究早期血小板和淋巴细胞比值(platelet/lymphocyte ratio,PLR)在老年ICU重症感染患者中的应用价值。方法回顾性分析笔者医院ICU收治的96例老年重症感染患者的临床资料。根据入住ICU时PLR值分为低PLR组(<115)、高PLR组(≥115)。比较两组患者临床指标,分析预后的影响因素。结果与低PLR组比较,高PLR组急性生理及慢性健康状况Ⅱ(acute physiology and chronic health evaluation scoring systemⅡ,APACHEⅡ)评分、中性粒细胞、C反应蛋白(C-reactive protein,CRP)、乳酸(lactic acid,Lac)、28天病死率明显升高,机械通气时间、ICU住院时间明显增加,Pa O2/Fi O2明显降低(P<0.05);多因素分析显示,APACHEⅡ评分、Lac、PLR是老年重症感染患者预后的独立危险因素(P<0.05); APACHEⅡ评分、Lac、PLR联合预测预后的敏感度、特异性分别为83.1%和81.9%,均显著高于3个指标单独评估的敏感度、特异性(P<0.05)。PLR的敏感度、特异性与APACHEⅡ评分均无显著性差异(P>0.05),二者敏感度、特异性均明显高于Lac(P<0.05)。结论早期PLR是ICU老年重症感染患者预后的独立危险因素,PLR水平升高可能预示不良预后。Objective To explore the application value of early platelet/lymphocyte ratio(PLR)for elderly patients with severe infection in ICU.Methods Clinical data of 96 cases of elderly patients with severe infection in ICU of our hospital were retrospectively analyzed.According to the PLR on admission of ICU,patients were divided into low PLR(<115)group,high PLR(≥115)group.Clinical indicators between two groups was compared,and the influence factors of prognosis were analyzed.Results Compared with low PLR group,higher PLR group had significantly higher APACHEⅡscore,neutrophils,CRP,Lac and 28d mortality rate,longer time of mechanical ventilation and ICU hospitalization,and lower PaO 2/FiO 2(P<0.05).Multivariate analysis showed that,APACHEⅡscore,Lac,PLRwere the independent risk factors of prognosis in elderly patients with severe infection in ICU(P<0.05).The sensitivity and specificity of combined detection of APACHEⅡscore,Lac,PLR in prognosis were 83.1%,81.9%,were higher than separate detection(P<0.05).The sensitivity and specificity of PLR were basically close to those of the APACHEⅡscore(P>0.05),and the sensitivity and specificity of PLR and APACHEⅡscore were significantly higher than those of Lac(P<0.05).Conclusion Early PLR is an independent risk factor for the prognosis of elderly patients with severe infection in ICU,and elevated PLR levels may indicate poor prognosis.

关 键 词：血小板和淋巴细胞比值 老年 重症感染 预后 

分 类 号：R459.7[医药卫生—急诊医学]