空腹血糖与淋巴细胞比值对急性胰腺炎持续脏器衰竭的早期预测价值  

Early Predictive Value of Fasting Glucose-to-Lymphocyte Ratio for Persistent Organ Failure in Acute Pancreatitis

作　　者：李洁 高鑫 潘阳 屠夏敏 罗小艳 路国涛[1,2] 肖炜明 严明权 LI Jie;GAO Xin;PAN Yang(Department of Gastroenterology/Pancreatic Center,Affiliated Hospital of Yangzhou University,Jiangsu 225000,China)

机构地区：[1]扬州大学附属医院消化内科/胰腺中心,225000 [2]江苏省扬州市胰腺病重点实验室,225000 [3]大连医科大学,116000

出　　处：《医学研究杂志》2024年第8期53-57,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(82070668);江苏省扬州市科技计划项目(YZ2021147)。

摘　　要：目的探讨空腹血糖与淋巴细胞比值(glucose-to-lymphocyte ratio,GLR)对急性胰腺炎(acute pancreatitis,AP)并发持续脏器衰竭(persistent organ failure,POF)的早期预测价值。方法收集2015年1月~2020年12月扬州大学附属医院消化内科/胰腺中心收治的677例AP患者,其中602例患者未发生POF(非POF组),77例患者并发POF(POF组)。收集患者的一般资料及入院24h以内的实验室指标,采用Logistic回归分析探讨AP并发POF的危险因素;绘制受试者工作特征(receiver operating characteristic,ROC)曲线,评估GLR、外周血中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板计数与淋巴细胞计数比值(platelet-to-lymphocyte ratio,PLR)、CT严重程度指数(computed tomography severity index,CTSI)、Ranon评分对AP并发POF的早期预测效能。结果POF组患者GLR、NLR、PLR、CTSI评分、Ranson评分显著高于非POF组(P<0.05),GLR为AP并发POF的独立危险因素。在最佳截断值为0.76时,GLR预测AP并发POF的曲线下面积(area under the curve,AUC)为0.745,敏感度及特异性分别为75.47%和59.80%。GLR预测AP并发POF的AUC优于PLR(z=2.868,P=0.004),与NLR、CTSI评分相当(z=1.304,P=0.183;z=0.538,P=0.588),而相较Ranson评分预测效能差(z=2.973,P=0.001)。结论GLR为AP并发POF的独立危险因素,可作为一种的用于预测AP患者早期发生POF的新型血液学指标。Objective To investigate the early predictive value of fasting glucose-to-lymphocyte ratio(GLR)in acute pancreatitis(AP)complicated by persistent organ failure(POF).Methods A total of 677 patients with AP admitted to the Department of Gastroenterology/Pancreatic Center,Affiliated Hospital of Yangzhou University from January 2015 to December 2020 were collected,of which 602 patients did not have POF(non-POF group)and 77 patients had concurrent POF(POF group).The general data and laboratory indicators within 24hours of admission were collected,and Logistic regression analysis was used to explore the risk factors of AP complicated with POF;receiver operating characteristic(ROC)curves were plotted to assess the early prediction efficiency of GLR,neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),computed tomography severity index(CTSI)and Ranson scores in predicting AP complicated with POF.Results GLR,NLR,PLR,CTSI score,and Ranson score were significantly higher in the POF group than those in the non-POF group(P<0.05),and GLR was an independent risk factor for AP complicated with POF.At an optimal cut-off value of 0.76,the area under the curve(AUC)of GLR for predicting AP complicated with POF was 0.745,with the sensitivity of 75.47% and the specificity of 59.80%.The AUC of GLR predicted AP complicated with POF was better than PLR(z=2.868,P=0.004),and was comparable to NLR and CTSI scores(z=1.304,P=0.183;z=0.538,P=0.588),and the predictive efficacy was worse compared with Ranson score(z=2.973,P=0.001).Conclusion GLR is an independent risk factor for AP complicated with POF and can be used as a better novel hematological indicator for predicting the early occurrence of POF in AP patients.

关 键 词：空腹血糖 淋巴细胞 急性胰腺炎 持续脏器衰竭 

分 类 号：R576[医药卫生—消化系统]