中性粒细胞/淋巴细胞比值联合急性胰腺炎严重程度床边指数对急性胰腺炎严重程度的预测价值  

Value of neutrophil to lymphocyte ratio combined with bedside index for severity in acute pancreatitis in predicting the severity of acute pancreatitis

作　　者：廖连 虞晓红 LIAO Lian;YU Xiaohong(Guizhou Medical University,Guiyang 550004,Guizhou Province,China;Department of Emergency,Jinyang Hospital Affiliated to Guizhou Medical University,Guiyang 550004,Guizhou Province,China;Department of Respiratory and Critical Medicine,Baiyun Hospital Affiliated to Guizhou Medical University,Guiyang 550004,Guizhou Province,China)

机构地区：[1]贵州医科大学,贵州贵阳550004 [2]贵州医科大学附属金阳医院急诊科,贵州贵阳550004 [3]贵州医科大学附属白云医院呼吸与重症医学科,贵州贵阳550004

出　　处：《新乡医学院学报》2023年第10期970-974,共5页Journal of Xinxiang Medical University

摘　　要：目的 探讨中性粒细胞/淋巴细胞比值(NLR)联合急性胰腺炎严重程度床边指数(BISAP)对急性胰腺炎(AP)严重程度的预测价值。方法 选择2021年1月至2022年6月贵州医科大学附属金阳医院收治的309例AP患者为研究对象,将患者分为重症急性胰腺炎(SAP)组和非SAP组,比较SAP组与非SAP组患者外周静脉血白细胞计数(WBC)、红细胞压积(HCT)、血小板(PLT)计数、平均血小板体积(MPV)、血小板分布宽度(PDW)、中性粒细胞计数(NEUT)、淋巴细胞(LYM)计数、NLR及BISAP评分、腹痛消失时间、住院时间、住重症监护病房(ICU)时间、机械通气率、持续肾脏替代治疗(CRRT)率和病死率,采用多因素logistic回归分析法筛选SAP的独立预测因素,绘制受试者操作特征(ROC)曲线,计算曲线下面积(AUC),分析NLR、BISAP评分及NLR联合BISAP评分对AP严重程度的预测价值。结果 SAP组患者的HCT、NEUT计数、NLR及BISAP评分显著高于非SAP组(P<0.05),LYM、PDW显著低于非SAP组(P<0.05);2组患者的WBC计数、PLT计数、MPV比较差异无统计学意义(P>0.05)。SAP组患者的腹痛消失时间、住院时间、住ICU时间显著长于非SAP组(P<0.05),机械通气率、CRRT率显著高于非SAP组(P<0.05);SAP组与非SAP组患者的病死率比较差异无统计学意义(P>0.05)。NLR(95%置信区间为1.060~1.171,P<0.001)、BISAP评分(95%置信区间为2.733~5.659,P<0.001)是SAP发生的独立危险因素。NLR、BISAP评分及NLR联合BISAP评分预测SAP的ROC曲线结果显示,NLR、BISAP评分、NLR联合BISAP评分的AUC值分别为0.801、0.857、0.881,敏感度分别为81.5%、75.3%、77.8%,特异度分别为68.9%、95.2%、95.6%。结论 NLR和BISAP评分是SAP发生的独立危险因素,可以作为预测SAP的指标,NLR及BISAP评分联合检测对SAP患者的预测价值优于单独NLR、BISAP评分。Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR)combined with bedside index for severity in acute pancreatitis(BISAP)score for the severity of acute pancreatitis(AP).Methods A total of 309 patients with AP admitted to Jinyang Hospital Affiliated to Guizhou Medical University from January 2021 to June 2022 were divided into severe acute pancreatitis(SAP)group and non-SAP group.The peripheral blood white blood cell(WBC)count,hematocrit(HCT),platelet(PLT)count,mean platelet volume(MPV),platelet distribution width(PDW),neutrophil count(NEUT),lymphocytes(LYM)count,NLR,BISAP score,time of abdominal pain disappearance,hospitalization time,time of stay in intensive care unit(ICU),mechanical ventilation rate,continuous renal replacement therapy(CRRT)rate,and mortality of patients were compared between the two groups.The independent predictors of SAP were identified by multivariate logistic regression analysis.Receiver operating characteristic(ROC)curves were plotted and the area under the curve(AUC)was calculated to analyze the predictive value of NLR,BISAP score and NLR combined with BISAP score for the severity of AP.Results The HCT,NEUT count,NLR and BISAP score of patients in the SAP group were significantly higher than those in the non-SAP group(P<0.05),while LYM count and PDW were significantly lower than those in the non-SAP group(P<0.05);there was no significant difference in WBC count,PLT and MPV of patients between the two groups(P>0.05).The time of abdominal pain disappearance,hospitalization time,and time of stay in ICU of patents in the SAP group were significantly longer than those in the non-SAP group(P<0.05);and the mechanical ventilation rate and CRRT rate were significantly higher than those in the non-SAP group(P<0.05);there was no significant difference in mortality of patients between the SAP group and non-SAP group(P>0.05).The NLR(95%confidence interval 1.060-1.171,P<0.001)and BISAP score(95%confidence interval 2.733-5.659,P<0.001)were independent risk factors for

关 键 词：急性胰腺炎 中性粒细胞/淋巴细胞比值 急性胰腺炎严重程度床边指数 

分 类 号：R657.51[医药卫生—外科学]