中性粒细胞/淋巴细胞、血小板/淋巴细胞预测心肺复苏术自主循环恢复患者预后的价值  

Predictive value of neutrophil/lymphocyte and platelet/lymphocyte on patients with spontaneous circulation recovery after cardiac arrest

作　　者：李超 吴允孚[1] 刘军[1] LI Chao;WU Yunfu;LIU Jun(Department of Critical Care Medicine,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu 215001,China)

机构地区：[1]南京医科大学附属苏州医院重症医学科

出　　处：《徐州医科大学学报》2019年第12期893-898,共6页Journal of Xuzhou Medical University

基　　金：江苏省第五期“333工程”科研项目(BRA2016070);苏州市临床重点病种诊疗技术专项(LCZX201607);苏州市科技发展计划(民生科技)项目(SS201874)

摘　　要：目的探讨外周血中性粒细胞与淋巴细胞比率(neutrophil-to-lymphocyte ratio,NLR)、血小板与淋巴细胞比率(platelet-to-lymphocyte ratio,PLR)对心跳骤停心肺复苏术后自主循环恢复患者住院病死率的预测价值。方法选取2012年4月-2018年11月南京医科大学附属苏州医院发生心跳骤停后自主循环恢复且入住重症医学科(ICU)超过24 h的患者,共30例。回顾性分析患者的临床资料,根据出院结局将其分为存活组和死亡组。比较2组患者入住ICU 24 h内及48~72 h NLR、PLR动态变化及组间差异,行多变量分析及ROC曲线探讨NLR、PLR对住院死亡率的预测价值。结果与存活组相比,死亡组患者入住ICU 24 h内PLR明显较低(P<0.05),而48~72 h NLR明显较高(P<0.05)。存活组患者入住ICU 48~72 h NLR较24 h明显降低(P<0.05);而死亡组患者48~72 h NLR、PLR较24 h无统计学差异(P>0.05)。多变量logistic回归分析及ROC曲线结果显示,入住ICU 48~72 h NLR是住院死亡率预测的独立危险因子,预测死亡结局时具有较高的敏感性和特异性。结论NLR和PLR有助于判断心跳骤停心肺复苏术后自主循环恢复患者的疾病结局。Objective To investigate the predictive value of peripheral bloodneutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)on in-patient mortality in patients with spontaneous circulation recovery after cardiac arrest.Methods A retrospective analysis was performed using clinical data from 30 patients who recovered from cardiac arrest in the Affiliated Suzhou Hospital of Nanjing University from April 2012 to November 2018 and were admitted to the intensive care unit for more than 24 h.The patients were divided into a survival group and a death group according to the outcome of discharge.The two groups were compared for the dynamic changes and differences in NLR and PLR within 24 h and 48-72 h after admission to ICU.Multivariate analysis and ROC curve were used to explore the predictive value of NLR and PLR for in-patient mortality.Results Compared with the survival group,PLR in the death group was significantly lower within 24 h of admission to ICU(P<0.05),while NLR in 48-72 h was significantly higher(P<0.05).The NLR of the survival group within 48-72 h of admission to ICU was significantly lower than that within 24 h(P<0.05).Compared with 24 h,no statistical difference was found as to NLR and PLR in the death group within 48-72 h of admission to ICU(P>0.05).Multivariate logistic regression analysis and ROC curve showed that NLR of 48-72 h in ICU was an independent risk factor for predicting in-patient mortality,and had high sensitivity and specificity in predicting death outcomes.Conclusions NLR and PLR can be helpful to judge the outcome of patients with spontaneous circulation recovery after cardiac arrest.

关 键 词：中性粒细胞/淋巴细胞 血小板/淋巴细胞 心跳骤停 住院病死率 预测因子 

分 类 号：R320.61[医药卫生—人体解剖和组织胚胎学]