NLR预测黄蜂蜇伤患者发生MODS的临床价值  

The clinical value of NLR in predicting Multiple Organ Dysfunction Syndrome(MODS)in patients with wasp stings

作　　者：马万宇 高建军 邹玉刚 马兴龙 李世松 曾廷武 刘龙 王小文 谢鹏 Ma Wanyu;Gao Jianjun;Zou Yugang;Ma Xinlong;Li Shisong;Zeng Tingwu;Liu Long;Wang Xiaowen;Xie Peng(Department of Emergency,the Third Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China;Department of Critical Care Medicine,the Third Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563000,China)

机构地区：[1]遵义医科大学第三附属医院急诊科,贵州遵义563000 [2]遵义医科大学第三附属医院重症医学科,贵州遵义563000

出　　处：《遵义医科大学学报》2020年第6期746-752,共7页Journal of Zunyi Medical University

基　　金：国家自然科学基金资助项目(NO:31660290);遵义市博士启动专项基金资助项目(NO:遵市科合HZ(2020)144)。

摘　　要：目的分析外周血中性粒细胞计数与淋巴细胞计数比值(NLR Neutrophil-to-lymphocyte ratio)预测黄蜂蛰伤患者发生多器官功能障碍综合征(MODS Multiple organ dysfunction syndrome)的价值。方法回顾性分析遵义医科大学第三附属医院2016年5月至2019年4月92例黄蜂蛰伤患者的临床资料,将患者分为MODS组、非多器官功能障碍综合征(NMODS,Non-multiple organ dysfunction syndrome)组,单因素分析两组间有差异指标,纳入多因素Logistic回归分析黄蜂蛰伤患者发生MODS的独立危险因素;用受试者工作特征性曲线(ROC)分析其预测价值。结果92例黄蜂蛰伤患者,MODS 32例,非MODS组60例,两组间NLR平均值35.83±18.23比8.99±4.52(P<0.001);NLR(OR=1.695,P=0.031)与肌酸激酶(CK)(OR=1.001,P=0.044)是黄蜂蛰伤患者发生MODS的独立危险因素;NLR预测黄蜂蛰伤发生MODS的AUC为0.953(P<0.001),最佳截断值为17.555时敏感度为87.5%,特异度为100%。结论NLR是黄蜂蛰伤患者发生MODS的危险因素,NLR对黄蜂蛰伤患者发生MODS具有很好预测价值。Objective To analyze the value of peripheral blood Neutrophil Ratio to Lymphocyte count(NLR)in predicting Multiple organ dysfunction syndrome(MODS)in patients with wasp stings.Methods The clinical data of wasp sting patients in the Third Affiliated Hospital of Zunyi Medical University from May 2016 to April 2019 were retrospectively analyzed.Patients were divided into MODS group and non-multiple organ dysfunction syndrome(NMODS)group.Single-factor analysis between these two groups was performed,followed by multivariate logistic regression to analyze the independent risk factors of MODS in wasp sting patients;The predictive value was analyzed using the Receiver Operating Characteristic Curve(ROC).Results There were 92 cases of wasp stings,32 cases of MODS,and 60 cases of non-MODS.The mean NLR between the two groups was 35.83±18.23 vs.8.99±4.52(P<0.001);NLR(OR=1.695,P=0.031)and creatine kinase(CK)(OR=1.001,P=0.044)were independent risk factors of MODS in patients with wasp stings.The AUC of NLR predicted the MODS of wasp stings was 0.953(P<0.001),and the sensitivity and specificity were 87.5%and 100%when the best truncation value was 17.555.Conclusion NLR is a more sensitive risk factor than CK for MODS,and has a good predictive value for MODS in patients with wasp stings.

关 键 词：黄蜂蛰伤 MODS 危险因素 NLR 

分 类 号：R646[医药卫生—外科学]