NLR、PLR和LMR在急性肺栓塞住院期间预后的价值  

Value of NLR,PLR and LMR in the Prognosis of Acute Pulmonary Embolism during Hospitalization.

作　　者：闫丹丹 史家欣 李家树 Yan Dandan;Shi Jiaxin;Li Jiashu(Department of Pulmonary and Critical Care Medcine,Xuzhou Medical University Affiliated Lianyungang Hospital,Jiangsu 222002,China)

机构地区：[1]徐州医科大学附属连云港医院呼吸与危重症医学科,222002

出　　处：《医学研究杂志》2021年第8期47-50,65,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81300052);江苏省青年医学重点人才基金资助项目(QNRC2016504)。

摘　　要：目的探讨炎性指标联合在急性肺栓塞(APE)患者住院期间预后中的临床价值。方法回顾性收集101例APE患者治疗前外周血中的中性粒细胞计数、淋巴细胞计数、血小板计数、单核细胞计数等指标,计算中性粒细胞淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)、淋巴细胞单核细胞比值(LMR),并根据住院期间有无不良事件的发生将患者分为预后不良组和预后良好组。结果预后不良组31例,预后良好组70例。单因素分析显示两组间年龄>60岁、白细胞计数、中性粒细胞计数、血小板计数、NLR、PLR、红细胞分布宽度、D-二聚体、肌钙蛋白Ⅰ升高、右心室功能不全、肺动脉收缩压和中央型肺栓塞比较差异有统计学意义(P<0.05)。多因素Logistic分析显示,白细胞计数、NLR、PLR、右心室功能不全和中央型肺栓塞均为影响患者预后不良的危险因素(OR>1,P<0.05)。NLR、PLR、NLR联合PLR对住院期间预后不良的受试者工作特征曲线下面积分别为0.825、0.758和0.833(P<0.05)。结论白细胞计数、NLR和PLR是APE患者住院期间预后不良的危险因素,NLR、PLR、NLR联合PLR对住院期间预后不良有中等程度的预测价值。Objective To explore the clinical value of inflammatory index combination in the prognosis of patients with acute pulmonary embolism(APE)during hospitalization.Methods The neutrophils,lymphocytes,platelets,monocytes and other indicators in the peripheral blood of 101 APE patients before treatment were retrospectively collected,and the neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and lymphocyte-monocyte ratio(LMR)were calculated.According to the occurrence of adverse events during hospitalization,patients were divided into poor prognosis group and good prognosis group(P<0.05).Results There were 31 cases in the poor prognosis group and 70 cases in the good prognosis group.Univariate analysis showed age>60 years old,white blood cells,neutrophils,platelets,NLR,PLR,red blood cell distribution width,D-dimer,elevated troponin I,right ventricular insufficiency,pulmonary artery systolic pressure and central type pulmonary embolism was significantly different between the two groups(P<0.05).Multivariate Logistic analysis showed that white blood cells,NLR,PLR,right ventricular insufficiency and central pulmonary embolism were all risk factors affecting the patient′s poor prognosis(OR>1,P<0.05).The area under the receiver operating characteristic curve of NLR,PLR,NLR combined with PLR for poor prognosis during hospitalization were 0.825,0.758 and 0.833(P<0.05).Conclusion White blood cells,NLR and PLR are risk factors for poor prognosis in APE patients during hospitalization.NLR,PLR,NLR combined with PLR have moderate predictive value for poor prognosis during hospitalization.

关 键 词：急性肺栓塞 中性粒细胞淋巴细胞比值 血小板淋巴细胞比值 淋巴细胞单核细胞比值 

分 类 号：R563[医药卫生—呼吸系统]