大理大学学报 ›› 2022, Vol. 7 ›› Issue (10): 94-100.

• 临床医学 • 上一篇    

NLR在脓毒症诊断及预后中的评估价值

程明璟,李福兴,王 黎,樊玉娟,肖 敏,熊苗苗,赵卫东*   

  1. (大理大学临床医学院,云南大理 671000)

  • 收稿日期:2022-03-07 修回日期:2022-04-10 出版日期:2022-10-15 发布日期:2022-11-15
  • 通讯作者: 赵卫东,副教授,博士,E-mail:wdzhao@dali.edu.cn。
  • 作者简介:程明璟,硕士研究生,主要从事临床微生物感染与免疫研究。
  • 基金资助:

    国家自然科学基金项目(81960363;82160361);云南省教育厅科学研究基金项目(2021Y429);云南省高层次卫生计生技术人才培养项目(H-2019045);云南省地方本科高校基础研究联合专项资金项目(202001BA070001-040)

Evaluation Value of NLR in the Diagnosis and Prognosis of Sepsis

Cheng Mingjing, Li Fuxing, Wang Li, Fan Yujuan, Xiao Min, Xiong Miaomiao, Zhao Weidong*   

  1. (Clinical College, Dali University, Dali, Yunnan 671000, China)

  • Received:2022-03-07 Revised:2022-04-10 Online:2022-10-15 Published:2022-11-15

摘要:

[摘要] 目的:探讨中性粒细胞-淋巴细胞比值(NLR)在脓毒症诊断及预后中的评估价值。方法:收集大理大学第一附属医院健康体检者50例(健康对照组)、同期入住重症监护室的非脓毒症患者50例(病例对照组)及脓毒症患者78例(脓毒症组)的一般资料及实验室资料,评估NLR对脓毒症的诊断价值和预后判断价值,分析判断NLR与序贯器官衰竭(SOFA)评分及降钙素原(PCT)的相关性,筛选NLR对脓毒症患者28 d病死率的最佳预测阈值和患者预后危险因素。结果:脓毒症组NLR水平较健康对照组和病例对照组显著升高,脓毒症组中死亡患者NLR水平显著高于生存患者,差异有统计学意义(P<0.01);NLR在脓毒症诊断和预后判断的受试者操作特征曲线的曲线下面积分别为0.81和0.75,并与SOFA评分、PCT呈正相关(P<0.001);NLR≥9.00的脓毒症患者28 d病死率显著升高(P<0.001);NLR在多元Logistic回归分析中OR值为1.128,调整混杂因素后OR值仍大于1。结论:NLR对脓毒症早期诊断的效能良好,对预测患者28 d病死率有一定价值。

关键词:

"> font-size:10.5pt, ">中性粒细胞-淋巴细胞比值, 脓毒症, 序贯器官衰竭评分

Abstract:

〔Abstract〕 Objective: To investigate the value of neutrophil-lymphocyte ratio(NLR) in the diagnosis and prognosis of sepsis.Methods: The general and laboratory data of 50 physical examiners(healthy control group), 50 non-septic patients(case control group) and 78 sepsis patients(sepsis group) were collected in the First Affiliated Hospital of Dali University. To evaluate the diagnostic value and prognostic value of NLR for sepsis,  the correlation between NLR and sequential organ failure assessment (SOFA) score and procalcitonin(PCT) was analyzed, and the best prediction threshold of NLR for 28-day mortality rate and patient prognostic risk factors in the patients with sepsis were screened. Results: The NLR level in the sepsis group was significantly higher than that in the healthy control group and the case control group, and the NLR level of the dead patients was significantly higher than that of the surviving patients in the sepsis group, and the differences were statistically significant(P<0.01). The area of NLR under ROC curve for diagnosis and prognosis of sepsis was 0.81 and 0.75, respectively, and was positively correlated with SOFA score and PCT(P<0.001). The 28-day mortality rate of sepsis patients with NLR≥9.00 was significantly higher(P<0.001). The OR value of NLR in the multiple Logistic regression analysis was 1.128, and the OR value was still greater than 1 after adjustment for confounding factors. Conclusion:NLR has a good diagnostic efficacy for sepsis and has a certain value in predicting the 28-day mortality rate of patients.

Key words:

"> font-size:10.5pt, ">neutrophil-lymphocyte ratio, sepsis, sequential organ failure assessment score

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