摘要
目的探讨中性粒细胞/淋巴细胞比值(NLR)在老年脓毒症患者急性肾损伤(AKI)诊断和预后中的价值。方法 157例老年脓毒症患者根据是否发生AKI分为AKI组(n=85)和非AKI组(n=72),回顾性分析2组的一般资料,评估AKI发生的可能危险因素,探讨NLR与老年脓毒症患者AKI严重程度的相关性及对预后的预测价值。结果 AKI组患者NLR高于非AKI组(P=0.000)。NLR、急性生理学与慢性健康状况评分系统II(APACHE II)及序贯性器官功能衰竭评估(SOFA)是老年脓毒症患者发生AKI的独立危险因素(OR=1.490, P=0.000;OR=1.277, P=0.014;OR=1.629,P=0.000)。NLR预测AKI的受试者工作特征曲线(ROC)曲线下面积为0.895,当NLR为15.22时预测AKI的有效性最佳。NLR与APACHE II评分有良好的相关性(r=0.664,P=0.000)。NLR预测脓毒症AKI患者死亡风险的曲线下面积为0.667,最佳截断值为21.04。结论 NLR可能与老年脓毒症患者AKI的发展有关,且可以判断AKI患者的严重程度和预后。
Objective To investigate the value of neutrophil/lymphocyte ratio(NLR)in the diagnosis and prognosis of acute renal injury(AKI)in elderly patients with sepsis.Methods According to the incidence of AKI,157 elderly patients with sepsis were divided into AKI group(n=85)and non-AKI group(n=72).The data of the two groups were retrospectively analyzed to assess the possible risk factors for the occurrence of AKI,to explore the correlation between NLR and the severity of AKI,and the predictive value of NLR for prognosis.Results The NLR of AKI group was higher than that of non-AKI group(P=0.000).NLR,Acute Physiology And Chronic Health Status Scoring System II(APACHEII)and Sequential Organ Failure Assessment(SOFA)scores are independent risk factors for AKI of elderly patients with sepsis(OR=1.490,P=0.000;OR=1.277,P=0.014;OR=1.629,P=0.000).The area under the ROC curve of NLR predicting AKI is 0.895,and it is most effective in predicting AKI when NLR is 15.22.There was a good correlation between NLR and APACHE II score(r=0.664,P=0.000).The area under ROC curve of NLR predicting mortality risk of elderly patients with septic AKI was 0.667,and the optimal cut-off value was 21.04.Conclusions NLR may be related to the development of AKI in elderly sepsis patients,and can be used to evaluate the severity and prognosis of AKI patients.
作者
韩蕊
丛燕
赵澐
Han Rui;Cong Yan;Zhao Yun(Department of Emergency,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)
出处
《老年医学与保健》
CAS
2020年第2期262-265,273,共5页
Geriatrics & Health Care
