改良格拉斯哥预后评分及计算炎症指标在煤工尘肺病中的含量及作用分析  

Analysis on content and effect of modifiedglasgow prognostic score and calculated inflammatory index in coal workers'pneumoconiosis

作　　者：贺腊姑 杨露祺 HE Lagu;YANG Luqi(Medical Laboratory Department,Hunan Prevention and Treatment Institute for Occupational Diseases,Changsha,Hunan 410000,China)

机构地区：[1]湖南省职业病防治院检验科,湖南长沙410000

出　　处：《职业与健康》2024年第15期2026-2031,共6页Occupation and Health

基　　金：湖南省职业病防治院2021年度院级科研课题(Y2021-013)。

摘　　要：目的评估改良格拉斯哥预后评分(modified glasgow prognostic score,mGPS),计算的炎症指标中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)和血小板/淋巴细胞比值(platelet/lymphocyteratio,PLR)在诊断煤工尘肺(coal workers'pneumoconiosis,CWP)中的作用,为CWP防治提供帮助。方法收集2022年1—12月湖南省职业病防治院154名CWP和120例健康对照者,采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评估PLR、NLR和mGPS预测CWP严重程度中的作用。分析CWP患者PLR、NLR、mGPS指标和肺功能指标之间的相关性。结果CWPⅢ组的患者白细胞[(8.20±3.30)×10^(9)/L]、中性粒细胞百分比值[(67.85±10.90)%]、中性粒细胞绝对值[(5.75±3.30)×10^(9)/L]和用力肺活量(77.29±18.49)水平相对于CWPⅡ组、Ⅰ组和对照组都明显增高,另外,CWPⅢ组的淋巴细胞百分比值[(21.67±9.38)%]、淋巴细胞绝对值[(1.62±0.70)×10^(9)/L]水平相对于其他3组水平降低。CWPⅢ期组相对于CWPⅠ组红细胞沉降率[(23.43±17.71)mm/h]和C-反应蛋白[(12.15±7.12)mg/L]水平增高,差异均有统计学意义(均P<0.05)。与其他3组相比,CWPⅢ期患者的血清NLR(5.32±2.64)和PLR(196.01±51.01)浓度显著升高(P<0.05)。同时,与CWPⅠ期及Ⅱ期患者相比,CWPⅢ患者的血清mGPS浓度显著升高(0.81±0.67)(P<0.05)。PLR、NLR、mGPS和FVC之间均呈负相关(r=-0.244、-0.197、-0.298,均P<0.05),PLR、NLR、mGPS和第1秒用力呼气量/用力肺活量的比值(forced expiratory flow in 1 s/forced vital capacity,FEV1/FVC)之间均呈负相关(r=-0.300、-0.225、-0.349,均P<0.05)。CWP组中NLR和PLR的ROC曲线下面积分别为0.767(95%CI:0.698~0.837,P<0.01)和0.626(95%CI:0.551~0.702,P<0.01)。结论PLR、NLR和mGPS可作为指示煤工尘肺患者炎症状态和病情严重程度的指标。与PLR相比,NLR对评估疾病的活动度更敏感。Objective To evaluate modified glasgow prognostic score(mGPS),calculated inflammatory markers such as neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)in the diagnosis of coal workers'pneumoconiosis(CWP),and to provide assistance for the prevention and treatment of CWP.Methods A total of 154 CWP patients and 120 healthy controls from Hunan Prevention and Treatment Institute for Occupational Diseases were collected from January to December 2022.The value of PLR,CAR,NLR and mGPS for predicting the prognosis of CWP were evaluated by receiver operating characteristic curve(ROC)and the correlation between the PLR,NLR,mGPS and lung function indicators of CWP patients were analyzed.Results The levels of leukocytes[(8.20±3.3)×10^(9)/L],percentage of neutrophils[(67.85±10.9)%],absolute value of neutrophils[(5.75±3.30)×10^(9)/L]and forced vital capacity(77.29±18.49)in patients in CWPⅢgroup were significantly increased compared with CWPⅡgroup,Ⅰgroup and control group.In addition,the percentage of lymphocytes[(21.67±9.38)%]and the absolute value of lymphocytes[(1.62±0.70)×10^(9)/L]in CWPⅢgroup were lower than those in the other three groups.Erythrocyte sedimentation rate[(23.43±17.71)mm/h]and C-reactive protein[(12.15±7.12)mg/L]levels in CWP stageⅢgroup were higher than those in CWPⅠgroup,and the differences were statistically significant(both P<0.05).Compared with the other three groups,the serum concentrations of NLR(5.32±2.64)and PLR(196.01±51.01)concentrations in CWP stageⅢpatients were significantly increased(both P<0.05).Meanwhile,compared with CWPⅠstage andⅡstage patients,the serum mGPS concentration in CWPⅢpatients was significantly increased(0.81±0.67)(both P<0.05).There was a negative correlation between PLR,NLR,mGPS and FVC(r=-0.244、-0.197、-0.298,all P<0.05),Meanwhile,PLR,NLR,mGPS and FEV_(1)/FVC were negatively correlated(r=-0.300、-0.225、-0.349,all P<0.05).The areas under the ROC curves of NLR and PLR were 0.767(95%CI:0.698-0.837)and 0.626(95%CI:0.551-0.7

关 键 词：煤工尘肺 血小板/淋巴细胞比值 中性粒细胞/淋巴细胞比值 改良格拉斯哥预后评分 

分 类 号：R135.2[医药卫生—劳动卫生]