摘要
目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)、血小板淋巴细胞比值(PLR)、急性生理与慢性健康评估(APACHE)Ⅱ评分对AECOPD患者院死亡评估价值。方法收集141例患者的临床资料,包括基本信息(性别、年龄),入院24 h内中性粒细胞计数、淋巴细胞计数、血小板计数、APACHEⅡ评分等。将其分为存活组及死亡组,统计NLR、PLR、APACHEⅡ评分在两组之间有无差异,运用ROC曲线评估NLR、PLR、APACHEⅡ评分对死亡患者的预测价值。结果NLR、PLR、APACHEⅡ评分在存活组(123例)及死亡组(18例)的均值分别为7.82±9.01、205.46±165.19、16.95±3.68及34.62±20.10、547.71±481.67、29.90±6.65,两组之间存在统计学差异(P<0.05)。ROC曲线显示NLR截断值为0.849(敏感度72.22%,特异度为82.11%),PLR截断值为323.68(敏感度61.11%,特异度为87.8%),APACHEⅡ评分截断值为25.7(敏感度55.56%,特异度为90.24%),NLR、PLR、APACHEⅡ评分对AECOPD患者的死亡均具有一定的预测价值,三者联合AUC值最大,为0.892对死亡的预测价值更佳。结论NLR、PLR、APACHEⅡ评分对慢性阻塞性肺病伴有急性加重患者的预后评估具有一定价值,三者联合具有最佳预测效果,且NLR、PLR是AECOPD患者简便、有效的预后因子。
Objective To investigate the value of peripheral blood neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)and acute physiology and chronic health evaluationⅡ(APACHEⅡ)in accessing the death of patients with acute obstructive pulmonary disease(AECOPD).Methods The clinical data of 141 patients were collected,including basic information(gender,age),neutrophil count,lymphocyte count,platelet count,and APACHEⅡscore within 24 hours after admission.They were divided into two groups based on prognosis,the death group and the survival group.The difference in NLR,PLR and APACHEⅡscores were compared between the two groups,and it used ROC curve to evaluate the predictive value of NLR,PLR and APACHEⅡ.Results The mean value of NLR,PLR,and APACHEⅡscores were 7.82±9.01,205.46±165.19,16.95±3.68,and 34.62±20.10,547.71±481.67,and 29.90±6.65 in the survival group(123 cases)and the death group(18 cases),respectively(P<0.05).The ROC showed that the NLR cutoff value was 0.849(sensitivity 72.22%,specificity 82.11%),the PLR cutoff value was 323.68(sensitivity 61.11%,specificity 87.8%),and the APACHEⅡscore cutoff value was 25.7(sensitivity 55.56%,specificity 90.24%).NLR,PLR,and APACHEⅡscores all had certain predictive value for the death of AECOPD patients,and the combination of the three had the highest AUC value(0.892),providing a better predictive value for death.Conclusion NLR,PLR and APACHEⅡscore have certain value in evaluating the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease,and the combination of the three indexes has the best predictive effect.NLR and PLR are simple and effective prognostic factors in AECOPD patients.
作者
葛学茹
陆友金
GE Xue-ru;LU You-jin(Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)
出处
《临床肺科杂志》
2020年第4期541-545,共5页
Journal of Clinical Pulmonary Medicine
