NLR、PLR、CLR、ACR联合检测在细菌性脓毒症中的应用价值  

Applicative Value of Combined Detection of NLR,PLR,CLR and ACR in Bacterial Sepsis

作　　者：缪凤霞 陈博[2] MIAO Fengxia;CHEN Bo(Department of Intensive Care Unit,Wuhu First People′s Hospital,Wuhu 241000,China;Department of General Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230001,China)

机构地区：[1]芜湖市第一人民医院重症医学科,安徽芜湖241000 [2]安徽医科大学第一附属医院普外科,安徽230001

出　　处：《医学综述》2022年第15期3110-3115,共6页Medical Recapitulate

摘　　要：目的探讨中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)、C反应蛋白-淋巴细胞比值(CLR)、白蛋白-C反应蛋白比值(ACR)联合检测在细菌性脓毒症中的应用价值。方法收集2018年4月至2021年3月芜湖市第一人民医院重症医学科收治的100例细菌性脓毒症患者的临床资料,根据患者后续是否出现休克分为休克组(43例)和无休克组(57例),依据患者28 d内生存情况分为生存组(74例)和死亡组(26例),比较休克组与无休克组、生存组与死亡组的临床资料,以及NLR、PLR、CLR、ACR联合检测在细菌性脓毒症中的预测价值。结果休克组患者C反应蛋白、NLR、CLR、序贯器官衰竭评分(SOFA)、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分均高于无休克组[69(25,188)mg/L比39(12,101)mg/L、23(11,40)比12(7,19)、122(28,571)比89(9,230)、8(8,12)分比6(5,9)分、(24±6)分比(18±4)分](P<0.05或P<0.01),而ACR低于无休克组[0.49(0.11,1.47)比0.93(0.21,3.53)](P<0.05)。死亡组患者C反应蛋白、NLR、CLR、SOFA评分、APACHEⅡ评分均高于生存组[48(29,188)mg/L比29(12,103)mg/L、36(5,74)比22(4,60)、121(28,496)比68(9,313)、10(8,13)分比6(5,9)分、(24.0±6.0)分比(17.2±3.7)分](P<0.05或P<0.01),血小板计数、PLR、ACR均低于生存组[68(19,399)×10^(9)/L比137(38,344)×10^(9)/L、40(19,1050)比79(28,1042)、0.34(0.11,1.37)比0.79(0.19,3.53)](P<0.05或P<0.01)。APACHEⅡ评分、SOFA评分以及NLR、PLR、CLR、ACR联合检测预测患者预后的曲线下面积分别为0.738、0.801、0.860。结论NLR、PLR、CLR、ACR联合检测对细菌性脓毒症患者病情程度和预后具有较高的预测价值,是临床常用评价体系的有效补充。Objective To investigate the applicative value of combined detection of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),C-reactive protein to lymphocyte ratio(CLR),and albumin to C-reactive protein ratio(ACR)in bacterial sepsis.Methods The clinical data of 100 patients with bacterial sepsis in ICU of Wuhu First People′s Hospital from Apr.2018 to Mar.2021 were collected and divided into a shock group(43 cases)and a non-shock group(57 cases)according to the subsequent occurrence of shock,and were divided into a survival group(74 cases)and a death group(26 cases)according to the survival within 28 days.The clinical data of the shock group and the non-shock group,the survival group and the death group were compared,and the applicative value of NLR,PLR,CLR and ACR combined detection in bacterial sepsis was analyzed.Results C-reactive protein,NLR,CLR,sequential organ failure assessment(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ)score in the shock group were higher than those in the non-shock group[69(25,188)mg/L vs 39(12,101)mg/L,23(11,40)vs 12(7,19),122(28,571)vs 89(9,230),8(8,12)vs 6(5,9),(24±6)vs(18±4)](P<0.05 or P<0.01),while ACR was lower than that of the non-shock group[0.49(0.11,1.47)vs 0.93(0.21,3.53)](P<0.05).The C-reactive protein,NLR,CLR,SOFA and APACHEⅡin the death group were higher than those in the survival group[48(29,188)mg/L vs 29(12,103)mg/L,36(5,74)vs 22(4,60),121(28,496)vs 68(9,313),10(8,13)vs 6(5,9),(24.0±6.0)vs(17.2±3.7)](P<0.05 or P<0.01),while platelet count,PLR and ACR were lower than those in the survival group[68(19,399)×10^(9)/L vs 137(38,344)×10^(9)/L,40(19,1050)vs 79(28,1042),0.34(0.11,1.37)vs 0.79(0.19,3.53)](P<0.05 or P<0.01).The area under the curve for predicting the patient prognosis of APACHEⅡscore,SOFA score and NLR,PLR,CLR,ACR combined detection were 0.738,0.801 and 0.860,respectively.Conclusion The combined detection of NLR,PLR,CLR and ACR has high predictive value in the disease severity and prognosis of the patients with b

关 键 词：细菌性脓毒症 中性粒细胞-淋巴细胞比值 血小板-淋巴细胞比值 C反应蛋白-淋巴细胞比值 白蛋白-C反应蛋白比值 联合检测 

分 类 号：R631.4[医药卫生—外科学]