中性粒细胞/淋巴细胞比值评估危重症患者预后的价值

doi:10.3969/j.issn.1006-6233.2017.04.007

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摘要 目的: 探讨中性粒细胞/淋巴细胞比值(NLR)对危重症患者的预后的评估价值。方法: 回顾性分析2012年1月至2013年9月入住我院ICU并符合纳入条件危重症患者的临床资料。按预后分组比较NLR、PCT、APACHEⅡ评分及SOFA评分的差异。单因素及多因素logistic回归分析评价其对危重症患者预后风险预测价值。计算其评价预后的ROC曲线下面积,并寻找出其预测危重症患者预后的最佳截断值。按截断值分组比较28d生存率。结果: 共计纳入200例,男性144例,女性56例。死亡患者NLR较存活患者明显增高。NLR[1.10(1.04~1.16),P<0.001]和APACHEⅡ分[1.10(1.01~1.20),P<0.001]是预测危重症患者预后的独立风险因素。NLR评价危重症患者预后的曲线下面积为76.2%,截断值为4.92。NLR>4.92组与NLR≤4.92组相比,28d生存率明显下降(P=0.002)。结论: NLR可以较好的预测危重症患者预后。

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	李振杰
	普隽
	袁红斌

关键词 ：中性粒细胞/淋巴细胞比值, 危重症, 死亡率

Abstract：Objective: To study the prognostic value of neutrophil-lymphocyte ratio (NLR) for predicting prognosis in critical ill patients. Methods: Adult patients who admitted our ICU from Jan. 2012 to Sep. 2013 and met inclusion criteria were included. NLR, PCT, APACHEII scores and SOFA scores according to the classification of different outcomes were compared. Univariate and multiple logistic regression analysis were used to identify potential independent risk factors for mortality. The performances of NLR in predicting mortality was assessed by receiver operating curves (ROC) and diagnostic parameters. The survival curves grouped by cut-off value of NLR were compared by using Kapla-Meier method. Results: Two hundred patients were included, among which 144 patients were male and the other 56 patients were female. According to classification of different outcomes, NLR in different groups had significant differences (P<0.05). NLR [1.10(1.04-1.16), p<0.001] and APACHEII scores [1.10(1.01-1.20), P<0.001] were the independent risk factors for mortality. The ROC of NLR for predicting mortality was 76.2% and the cut-off value was 4.92. Patients with NLR more than 4.92 had significantly lower survival rates than those with NLR less than 4.92 (P=0.002). Conclusion: NLR is an effective predictor of clinical outcomes in critical ill patients.

Key words： NLR Critical ill Mortality

基金资助:上海市科技计划项目,(编号:201202682)

通讯作者: 袁红斌

引用本文:

李振杰, 普隽, 袁红斌. 中性粒细胞/淋巴细胞比值评估危重症患者预后的价值[J]. 河北医学, 2017, 23(4): 550-554.
LI Zhenjie, PU Jun, YUAN Hongbin. Prognostic Value of Neutrophil -lymphocyte Ratio in Critical ill Patients. 河北医学, 2017, 23(4): 550-554.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2017.04.007 或 http://www.hbyxzzs.cn/CN/Y2017/V23/I4/550

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