血小板/淋巴细胞比值对肾综合征出血热患者的预测价值分析  

Analysis on predictive value of platelet to lymphocyte ratio in hemorrhagic fever with renal syndrome

作　　者：孟欣[1] 王聪[1] 张宁[1] MENG Xin;WANG Cong;ZHANG Ning(Department of Clinical Laboratory,the First Affiliated Hospital of Xi′anJiaotong University,Xi′an,Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院检验科

出　　处：《国际检验医学杂志》2019年第19期2340-2343,2347,共5页International Journal of Laboratory Medicine

基　　金：陕西省自然科学基础研究计划项目(2017JM8084)

摘　　要：目的探讨血小板/淋巴细胞比值(PLR)对肾综合征出血热(HFRS)患者预测价值的临床应用。方法选取2015年1月至2018年4月该院收治的120例HFRS患者,同时选取120例上呼吸道感染患者为疾病对照组,150例体检健康者作为健康对照组。比较PLR、血小板(PLT)、淋巴细胞(LC)等指标在各组中的表达差异。收集HFRS患者的临床和实验室资料,统计分析各指标的差异,并采用受试者工作特征曲线(ROC曲线)分析PLT、PLR对HFRS的诊断和预测价值。结果 HFRS患者LC、血小板体积分布宽度(PDW)、尿素氨(BUN)、肌酐(CREA)水平显著高于疾病对照组和健康对照组,PLT、PLR显著低于疾病对照组和健康对照组,差异具有统计学意义(P<0.05)。疾病对照组与健康对照组两组比较,LC、PDW明显降低,PLR明显升高,差异具有统计学意义(P<0.05)。PLT、BUN、CREA在疾病对照组与健康对照组比较差异无统计学意义(P>0.05)。PLR、PLT预测HFRS的ROC曲线下面积(AUC)分别为0.923、0.967,PLT预测HFRS临界值为104(灵敏度0.908,特异度0.993),PLR预测HFRS临界值为45.28(灵敏度0.775,特异度0.993)。PLR和PLT预测HFRS IgM阳性患者AUC分别为0.928和0.970。PLT及PDW诊断HFRS重型患者的AUC分别为0.642(95%CI:0.530~0.754,P=0.023),0.662(95%CI:0.545~0.780,P=0.010)。联合PLT及PDW诊断HFRS重型患者的AUC为0.707。结论 PLR、PDW和PLT可作为一种独立预测HFRS患者的生物标志物,对预测HFRS患者及其严重程度具有重要的临床价值,能够为HFRS患者的预后管理提供理论依据。Objective To investigate the predictive value of platelet to lymphocyte ratio(PLR)in hemorrhagic fever with renal syndrome(HFRS).Methods 120 patients with HFRS and 120 patients with upper respiratory infection(URI)as disease control group and 150 individuals undergoing the healthy physical examination(healthy controls group)were selected in a hospital from January 2015 to April 2018.Blood cells classification and count were performed.PLR were compared among two groups.The clinical and laboratory data in the patients with HFRS were collected and other indicators were statistically analyzed.Moreover,the diagnostic and predictive value of PLR、PLR were analyzed using the receiver operating characteristic curve(ROC curve).Results LC,PDW,BUN and CREA in the HFRS patients were significantly higher than disease control group and the healthy controls group,PLT and PLR were significantly lower than disease control group and healthy controls group,the difference was statistically significant(P<0.05).LC,PDW were significantly lower in disease control group than healthy controls group,PLR was significantly higher in disease control group than healthy controls group,the difference was statistically significant(P<0.05).There was no significant difference of PLT,BUN,CREA in disease control group and healthy controls group(P>0.05).The AUC value of PLR,PLT for predicting HFRS was 0.923,0.967,the cutoff value of PLR was 45.28(sensitivity was0.775,specificity was 0.993),the cutoff value of PLT was 104(sensitivity was 0.908,specificity was 0.993).The AUC value of PLR and PLT for predicting HFRS IgM positive patients were 0.928 and 0.970,respectively,The AUC value of severe HFRS patients diagnosed by PLT and PDW was 0.642(95%CI:0.530-0.754,P=0.023),0.662(95%CI:0.545-0.780,P=0.010).The AUC value of PLT and PDW for predicting HFRS severe patients was 0.707.Conclusion PLR,PDW and PLT are expected to apply as a new biomarker for independently predicting the HFRS and have important clinical value for prediction of HFRS patients and their

关 键 词：肾综合征出血热 血小板/淋巴细胞比值 预测价值 

分 类 号：R512.8[医药卫生—内科学]