外周血NLR联合PLR对主动脉夹层的诊断意义  

The diagnosis value of peripheral blood NLR combined with PLR in the diagnosis of acute aortic dissection

作　　者：刘洁香[1] 徐宁[1] 胡蛟龙[2] 李俊文[1] LIU Jiexiang;XU Ning;HU Jiaolong;LI Junwen(Department of Cardiology,the Second People's Hospital of Foshan,Foshan 528000,Guangdong,China;Department of Emergency,the Second People's Hospital of Foshan,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市第二人民医院心内科,广东佛山528000 [2]佛山市第二人民医院急诊科,广东佛山528000

出　　处：《贵州医科大学学报》2021年第8期981-986,共6页Journal of Guizhou Medical University

基　　金：佛山市卫生健康局医学科研课题(20200241)。

摘　　要：目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)对主动脉夹层(AD)患者的诊断意义。方法明确诊断的AD患者病例34例(AD组)、急性ST段抬高型心肌梗死病例48例(STEMI组)和低危胸痛病例50例(低危胸痛组),收集3组患者基础疾病等资料、记录入院时首次血常规检测的中性粒细胞计数(NEUT)、淋巴细胞计数(LYM)、血小板计数(PLT)等数据,计算NLR及PLR,应用受试者工作(ROC)曲线评估NLR和PLR对AD的诊断作用。结果AD组和STEMI组NEUT和NLR明显高于低危胸痛组(P<0.001),AD组PLT和PLR明显低于STEMI组(P分别为<0.001、0.006);AD组PLT明显低于低危胸痛组(P<0.001),且PLR亦有下降趋势(P=0.07);STEMI组与低危胸痛组PLT和PLR比较,差异无统计学意义(P分别为0.402、0.233);PLR诊断AD的能力曲线下面积(AUC)为0.655(P=0.008),NLR筛查STEMI和AD等高危胸痛的能力AUC为0.778(P<0.001),PLR对NLR筛选出的高危胸痛病例中AD的诊断能力AUC为0.683(P=0.006),应用NLR联合PLR的方法较单用PLR诊断AD的特异性有明显提高(χ^(2)=12.027,P=0.001)。结论NLR联合PLR的方法可用于AD的诊断,并有较高的特异性。Objective To investigate the diagnostic value of neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)for patients with aortic dissection(AD).Methods Thirty-four patients with AD were selected as the AD group,forty-eight patients with acute ST-segment elevation myocardial infarction(STEMI)as the STEMI group and 50 low-risk patients with chest pain as the control group.The general conditions,neutrophil count(NEUT),lymphocyte count(LYM),platelet count(PLT),NLR and PLR were compared among the three groups.The diagnostic values of NLR and PLR for AD were evaluated by ROC curve.Results The NEUT and NLR in AD and STEMI groups were significantly higher than those in the control group(P<0.001).The PLT and PLR of AD group were remarkably lower than those in STEMI group(P<0.001,0.006,respectively).The PLT was obviously lower(P<0.001)and the PLR decreased more(P=0.07)in the AD group than those in the control group.The PLT and PLR had no statistical difference between the STEMI group and the control group(P=0.402,0.233,respectively).The curve(AUC)of PLR in the diagnosis of AD was 0.655(P=0.008),the AUC of NLR in the diagnosis of high-risk chest pain was 0.778(P<0.001),the AUC of PLR in the diagnosis of AD with high-risk chest pain was 0.683(P=0.006).NLR combined with PLR had higher specificity in the diagnosis of AD(90.81%)than PLR alone(χ^(2)=12.027,P=0.001).Conclusions The role of NLR combined with PLR may have higher diagnostic value of AD in patients with acute chest pain.

关 键 词：主动脉夹层 中性粒细胞与淋巴细胞比值 血小板与淋巴细胞比值 诊断 

分 类 号：R561.3[医药卫生—呼吸系统]