摘要
目的探讨淋巴细胞/白细胞比值(LWR)、中性粒细胞/淋巴细胞比值(NLR)、中性粒细胞/单核细胞比值(NMR)、血小板/中性粒细胞比值(PNR)、血小板/淋巴细胞比值(PLR)在新型冠状病毒肺炎(COVID-19)患者接受重症治疗中的诊断价值。方法收集2020年1月21日至3月1日初次就诊于南阳市中心医院的的COVID-19患者血常规指标,根据是否接受重症监护治疗分为ICU治疗组和非ICU治疗组,分析血常规比值在两组之间的差异性和诊断价值,并探讨血常规比值在评估患者预后中的临床价值。结果与非ICU治疗组相比,ICU治疗组的平均年龄升高(60.13±9.5vs 44.97±16.73,Z=3.54,P<0.001),住院天数延长(14.88±4.03 vs 10.65±6.41,Z=2.49,P=0.013)。ICU治疗组的白细胞计数、中性粒细胞计数、NLR、NMR和PLR值均升高(Z值分别为3.08、3.90、4.81、4.42、3.74,P均<0.05),淋巴细胞计数、LWR、LMR、PWR和PNR值均降低(Z值分别为-3.67、-4.71、-2.54、-2.17、-3.08,P均<0.05)。NLR在判断接受ICU治疗诊断价值的AUC最大(AUC=0.919,95%CI:0.840~0.998,P<0.05),当截断值为3.695时,其敏感度和特异度分别为93.7%、86.5%,约登指数为0.802。LWR、PWR和PNR与住院天数之间呈负相关(rs分别为-0.473、-0.347和-0.343,P均<0.05),NLR和NMR与住院天数之间呈正相关(rs分别为0.438、0.371,P均<0.05)。结论COVID-19患者早期血常规指标比值有助于临床医师更快地评估患者的免疫炎症状态,从而迅速筛查出需要重症监护治疗的患者,更好地采取适当措施改善症状。
Objective To explore the diagnostic value of lymphocyte/leukocyte ratio(LWR),neutrophil/lymphocyte ratio(NLR),neutrophil/monocyte ratio(NMR),platelet/neutrophil ratio(PNR),platelet/lymphocyte ratio(PLR)in treatment of severe coronavirus disease 2019(COVID-19).Methods The blood routine indicators of COVID-19 patients,who were diagnosed in Nanyang Central Hospital from January 21 to March 1,2020 for the first time,were collected,and divided into ICU treatment group and non-ICU treatment group according to whether they received intensive care treatment.The difference and diagnosis value of the ratios of blood routine indicators between the two groups were analyzed,and the clinical value of ratios of blood routine indicators in assessing the prognosis of patients was explored.Results The average age and hospitalization days of patients in the ICU treatment group were both significantly higher than those in the non-ICU group(average age:60.13±9.5 vs44.97±16.73,Z=3.54,P<0.001;average hospitalization days:14.88±4.03 vs 10.65±6.41,Z=2.49,P=0.013).White blood cell count,neutrophil count,NLR value,NMR value and PLR value in the ICU treatment group were significantly higher than those in the non-ICU group(Z values were 3.08,3.90,4.81,4.42,3.74,respectively,all P<0.05),while the values of lymphocyte count,LWR value,LMR value,PWR value and PNR value in the ICU treatment group were all significantly lower than those in the non-ICU group(Z values were-3.67,-4.71,-2.54,-2.17,-3.08,respetively,all P<0.05).NLR had the largest AUC in judging the value of receiving ICU treatment and diagnosis(AUC=0.919,95%CI:0.840-0.998,P<0.01);when the cut-off value was 3.695,the sensitivity and specificity were 93.7%and 86.5%,respectively,and the Youden index was 0.802.LWR,PWR and PNR were negatively correlated with hospitalization days(rswere-0.473,-0.347,and-0.343,respectively,all P<0.05),while NLR and NMR were positively correlated with hospitalization days(rswere 0.438,0.371,respectively,all P<0.05).Conclusion The ratios of early blood rou
作者
胡天喜
闫彬
杜伟鹏
夏盼盼
段金霞
HU Tianxi;YAN Bin;DU Weipeng;XIA Panpan;DUAN Jinxia(Clinical Medicine Laboratory,Nanyang Central Hospital,Nanyang 473000,China;Department of Infectious Diseases,Nanyang Central Hospital)
出处
《河南预防医学杂志》
2022年第5期330-334,共5页
Henan Journal of Preventive Medicine
基金
河南省重点研发与推广专项科技攻关项目(212102310805)
南阳市重点研发与推广专项科技攻关项目(KJGG093)。
