中性粒细胞/淋巴细胞比值、血糖变异度对脓毒症患者预后的预测价值  

Prognostic value of neutrophil-to-lymphocyte ratio and glycemic variability in patients with sepsis

作　　者：厉丹瑜 姚佳丽 童洪杰[1] 陈琨[1] LI Danyu;YAO Jiali;TONG Hongjie;CHEN Kun(Department of Critical Care Medicine,Jinhua Central Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市中心医院重症医学科,浙江金华321000

出　　处：《中国现代医生》2025年第5期53-56,共4页China Modern Doctor

摘　　要：目的探讨中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血糖变异度(glycemic variability,GV)对脓毒症患者预后的预测价值。方法选取2023年1月至2024年1月在金华市中心医院住院的121例脓毒症患者,根据患者确诊脓毒症28d内是否死亡分为存活组(n=68)和死亡组(n=53)。记录患者确诊脓毒症后第1~3天的血糖水平,计算GV。对脓毒症患者预后的危险因素进行二元Logistic回归分析。评估相关指标对脓毒症患者预后的预测价值采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)。结果与存活组比较,死亡组患者的嗜中性粒细胞计数、急性生理学与慢性健康状况评分Ⅱ、降钙素原、NLR、GV水平升高(P<0.05),而淋巴细胞计数降低(P<0.05)。Logistic回归分析结果表明,NLR与GV是影响脓毒症患者预后的独立危险因素。ROC曲线分析结果显示,NLR的曲线下面积(area under the curve,AUC)为0.814,GV的AUC为0.805。结论NLR和GV可能是影响脓毒症患者预后的独立危险因素,对脓毒症患者的预后有一定预测价值。Objective To investigate the prognostic value of neutrophil-to-lymphocyte ratio(NLR)and glycemic variability(GV)in patients with sepsis.Methods A total of 121 sepsis patients hospitalized in Jinhua Central Hospital from January 2023 to January 2024 were selected and divided into survival group(n=68)and death group(n=53)according to whether they died within 28d of confirmed sepsis.Blood glucose levels on the first 1-3 days after the diagnosis of sepsis were collected,and GV was calculated.The risk factors impacting the prognosis of patients with sepsis were analyzed through binary Logistic regression.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of relevant indicators.Results Compared with survival group,the levels of neutrophil count,acute physiology and chronic health evaluationⅡ(APACHEⅡ),procalcitonin,NLR and GV levels in death group were significantly increased(P<0.05),while lymphocyte was decreased(P<0.05).Logistic regression analysis indicated that NLR and GV might be independent risk factors affecting the prognosis of sepsis patients(P<0.05).ROC curve showed area under the curve(AUC)of NLR was 0.814 and GV AUC was 0.805.Conclusion NLR and GV could potentially be independent risk factors affecting the prognosis of sepsis patients,and they hold a certain degree of predictive worth for the prognosis of sepsis patients.

关 键 词：血糖变异度 中性粒细胞/淋巴细胞比值 脓毒症 

分 类 号：R589[医药卫生—内分泌]