摘要
目的探讨中性粒细胞与淋巴细胞比值(NLR)在急性胰腺炎(AP)并发急性呼吸窘迫综合征(ARDS)中的预测价值。方法回顾性分析2015 年10 月—2018 年2 月山西省人民医院收治符合入组标准的93 例确诊为急性胰腺炎(AP)患者的临床资料。根据2012 年ARDS 柏林标准,按是否发生ARDS 分为ARDS阳性组和ARDS 阴性组,观察两组患者临床指标、生化指标及NLR。采用受试者操作特征(ROC)曲线和Logistic 回归分析评估NLR、白细胞计数(WBC)对AP 并发ARDS 的预测价值。结果 93 例符合标准的患者,其中ARDS 阳性组18 例,ARDS 阴性组75 例。两组患者WBC、中性粒细胞计数(ANC)、淋巴细胞计数(ALC)、NLR、淋巴细胞与单核细胞比值(LMR)及心率的比较,差异有统计学意义(P <0.05)。ROC 曲线下最佳临界值为:NLR 15.43、WBC 17.05×10^9/L,ROC 曲线下面积分别为NLR 0.948、WBC 0.869,联合检测为0.955。NLR 和WBC 串联检测时预测AP 发生ARDS 的特异性最高,为100%;NLR 和WBC 并联检测时预测AP 发生ARDS 的敏感性最高为是88.9%(误诊率11.1%)。结论 NLR、WBC 与AP 并发ARDS 密切相关,且两者联合检测对早期预测AP 并发ARDS 的特异性和敏感性最高。
Objective To explore the predictive value of neutrophil-lymphocyte ratio (NLR) and WBC in severe acute pancreatitis (SAP) complicated with ARDS. Methods The clinical data of 93 patients of acute pancreatitis (AP) who were admitted to Shanxi Provincial People’s Hospital during October 2015 to February 2018 were analyzed retrospectively. According to ARDS Berlin criteria in 2012, the patients was divided into ARDS group and ARDS-negative group. The clinical indicators, biochemical indicators and NLR of the two groups were observed. The t-test and chi-square test were used to compare the NLR and other indicators between the two groups. The receiver operating characteristic (ROC) curve and logistic regression analysis were used to evaluate the predictive value of NLR for AP complicated with ARDS. Results Of the 93 patients who met the criteria, 18 were in the ARDS-positive group and 75 in the ARDS-negative group. There were significant differences in WBC, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), NLR, lymphocyte-to-monocyte ratio (LMR), and heart rate between the two groups (P < 0.05). The optimal cutoff values under the ROC curve for NLR and WBC was 15.43 and 17.05×10^9/L, respectively. The area under the ROC curve for NLR, WBC or combination of NLR and WBC was 0.948, 0.869, and 0.955, respectively. The specificity and sensitivity for combined NLR and WBC was 100% and 88.9%, respectively. Conclusions NLR and WBC are closely related to ARDS in AP patients. Combination of NLR and WBC has the highest specificity and sensitivity for early prediction of AP complicated with ARDS.
作者
张荟杰
王美红
王俊平
栗凤霞
Hui-jie Zhang;Mei-hong Wang;Jun-ping Wang;Feng-xia Li(People’s Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi 030012, China;Department of Gastroenterology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi 030012, China)
出处
《中国现代医学杂志》
CAS
2019年第17期79-83,共5页
China Journal of Modern Medicine
