中性粒细胞与淋巴细胞比值、中性粒细胞与血清白蛋白比值对非紫绀型先天性心脏病术后拔管时机的评估价值  

Value of neutrophil-to-lymphocyte ratio and neutrophil-to-serum albumin ratio in assessing the timing of postoperative extubation in noncyanotic congenital heart disease

作　　者：闫丽伟 陈志刚[1] 吴振宇[2] YAN Liwei;CHEN Zhigang;WU Zhenyu(The First Affiliated Hospital of Xinxiang Medical University,Henan Province,Xinxiang 453100 China;Ward Three,Department of Cardiac Surgery,Henan Provincial Chest Hospital,Henan Province,Zhengzhou 450000,China)

机构地区：[1]新乡医学院第一附属医院,河南新乡453100 [2]河南省胸科医院心外科三病区,河南郑州450000

出　　处：《妇儿健康导刊》2025年第4期193-198,共6页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)、中性粒细胞与血清白蛋白比值(NAR)对非紫绀型先天性心脏病(CHD)术后拔管时机的评估价值。方法选取2021年6月至2023年6月在河南省胸科医院接受体外循环下心内直视手术的220例非紫绀型CHD患儿为研究对象,将CHD术后72h内未能成功拔管或拔管后24h内再次机械通气的患儿纳入晚期拔管组,反之纳入早期拔管组。比较两组临床资料、NLR及NAR、临床结局,分析非紫绀型CHD术后拔管时机的影响因素,绘制NLR、NAR的受试者工作特征曲线,分析其对非紫绀型CHD术后拔管时机的评估价值。结果晚期拔管组24例(10.91%),早期拔管组196例(89.09%)。晚期拔管组的NLR、NAR高于早期拔管组,差异有统计学意义(P<0.05)。晚期拔管组的机械通气时间、重症监护室滞留时间、住院天数长于早期拔管组(P<0.05)。多因素logistic回归分析显示,NLR、NAR均为非紫绀型CHD术后拔管时机的影响因素(P<0.05)。NLR与NAR联合评估非紫绀型CHD术后拔管时机的曲线下面积为0.859,灵敏度为79.17%,特异度为80.10%。结论NLR、NAR对非紫绀型CHD术后拔管时机具有一定的评估价值,可为临床决策提供参考。Objective To explore the evaluation value of neutrophil-to-lymphocyte ratio(NLR)and neutrophil-to-serum albumin ratio(NAR)in assessing the timing of postoperative extubation in noncyanotic congenital heart disease(CHD).Methods Two hundred and twenty children with noncyanotic CHD who underwent endocardial direct vision surgery under extracorporeal circulation in Henan Provincial Chest Hospital from June 2021 to June 2023 were selected as the study subjects,and those who were unsuccessful to extubate within 72 hours after CHD surgery or who were re-mechanically ventilated within 24 hours after extubation were included in the late extubation group,and vice versa in the early extubation group.The clinical data,NLR and NAR,and clinical outcomes of the two groups were compared to analyze the factors influencing the timing of postoperative extubation in noncyanotic CHD,and the receiver operating characteristic curve of NLR and NAR was plotted to analyze the value of their assessment on the timing of postoperative extubation in noncyanotic CHD.Results There were 24 cases(10.91%)in the late extubation group and 196 cases(89.09%)in the early extubation group.NLR and NAR in the late extubation group were higher than those in the early extubation group,and the differences were statistically significant(P<0.05).The duration of mechanical ventilation,intensive care unit stay,and hospitalization days in the late extubation group were longer than those in the early extubation group(P<0.05).Multifactorial logistic regression analysis showed that both NLR and NAR were influential factors in the timing of postoperative extubation in noncyanotic CHD(P<0.05).The area under the curve of NLR combined with NAR for assessing the timing of postoperative extubation in noncyanotic CHD was 0.859,with a sensitivity of 79.17%and a specificity of 80.10%.Conclusion NLR and NAR are valuable in assessing the timing of postoperative extubation in noncyanotic CHD and can inform clinical decision making.

关 键 词：非紫绀型先天性心脏病 中性粒细胞与淋巴细胞比值 中性粒细胞与血清白蛋白比值 术后拔管时机 

分 类 号：R725.4[医药卫生—儿科]