中性粒细胞与淋巴细胞比值与反流性食管炎严重程度的相关性研究  

Correlation of neutrophil-lymphocyte ratio with the severity of reflux esophagitis

作　　者：王海明 徐莉敏[1] 田涛[2] 石益海[2] 李波静[2] WANG Haiming;XU Limin;TIAN Tao;SHI Yihai;LI Bojing(Department of Clinical Laboratory,Gongli Hospital of Pudong New Area,Shanghai 200135,China;Department of Gastroenterology,Gongli Hospital of Pudong New Area,Shanghai 200135,China)

机构地区：[1]上海市浦东新区公利医院检验科,上海200135 [2]上海市浦东新区公利医院消化内科,上海200135

出　　处：《中国研究型医院》2021年第6期57-61,共5页Chinese Research Hospitals

基　　金：2017年度“浦东新区卫生系统特色专病”胃食管反流病项目(PWZzb2017-08);上海市浦东新区卫生系统重点学科群建设资助项目(PWZxq2017-15)。

摘　　要：目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)与反流性食管炎胃镜诊断严重程度分级的相关性。方法搜集我院胃食管反流病数据库中2019年1月至2020年12月在消化科门诊就诊的胃食管反流病患者资料,选取(GerdQ)量表评分≥8分的391例反流性食管炎患者(患者组)与400例同期健康体检者(对照组)进行回顾性研究。根据胃镜下洛杉矶分级将反流性食管炎患者分为轻度组(LA-A级)和中重度组(LA-B级、LA-C级、LA-D级)。胃镜检查前1天患者均行血常规检查,采用非参数检验Mann-Whitney U统计方法分别比较对照组和患者组;反流性食管炎轻度组和中重度组的NLR水平;采用受试者工作特征曲线(ROC)计算NLR对反流性食管炎严重程度的预测价值。结果与对照组相比,患者组的NLR、白细胞(WBC)、中性粒细胞(Neut)水平升高,红细胞体积分布宽度(RDW)、淋巴细胞(Lym)降低,两组比较差异有统计学意义(Z值分别为7.172、1.580、4.762、2.614、5.129;P值均<0.001);与反流性食管炎轻度组相比,反流性食管炎患者中重度组的NLR、RDW、Neut高于轻度组,两组比较有统计学意义(Z值分别为2.395、2.614、2.163;P值均<0.05);ROC分析显示,当NLR的截断值为1.92时,曲线下面积、敏感度、特异度分别为0.570、66%、48%。结论NLR可能与反流性食管炎患者的严重程度有关,NLR可作为诊断反流性食管炎严重程度的重要指标。Objective To investigate the correlation between peripheral blood neutrophillymphocyte ratio(NLR)and gastroscopic diagnostic severity grading of reflux esophagitis.Methods The data of patients with gastroesophageal reflux disease who attended the gastroenterology outpatient clinic from January 2019 to December 2020 were collected from our gastroesophageal reflux disease database.391 patients with reflux esophagitis with a scale(GerdQ)score≥8(patient group)were selected for a retrospective study with 400 concurrent healthy physical examiners(control group).Patients with reflux esophagitis were divided into a mild group(LA-A grade)and moderate to severe group(LA-B,LA-C,LA-D grade)according to gastroscopic LA grading.All patients underwent routine blood tests one day before gastroscopy,and the Mann-Whitney U statistical method was used to compare the control and patient groups separately using a nonparametric test,and NLR levels in the mild and moderate-severe reflux esophagitis groups;the predictive value of NLR on the severity of reflux esophagitis was calculated using the receiver operating characteristic(ROC)curves.Results Compared to the control group,the patient group had higher levels of NLR,white blood cells(WBC),and neutrophils(Neut)and lower red blood cell volume distribution width(RDW)and lymphocytes(Lym),with statistically significant differences between the two groups(Z=7.172,1.580,4.762,2.614,5.129;all P<0.001).NLR,RDW,and Neut were higher in the moderate to severe reflux esophagitis patient group than the mild group,and the comparison between the two groups was statistically significant(Z=2.395,2.614,2.163;all P<0.05);ROC analysis showed that when the cut-off value of NLR was 1.92,the area under the curve,sensitivity and specificity were 0.570,66%,and 48%,respectively.Conclusion NLR may correlate with the severity of patients with reflux esophagitis,and NLR may be a critical indicator for the diagnosis of reflux esophagitis.

关 键 词：胃食管反流 中性粒细胞与淋巴细胞比值 胃镜检查 ROC曲线 

分 类 号：R571[医药卫生—消化系统]