中国全科医学2017，Vol.20Issue(5)：533-537,5.DOI:10.3969/j.issn.1007-9572.2017.05.006
中性粒细胞与淋巴细胞比值预测脓毒症患者预后的价值研究
Value of Neutrophil to Lymphocyte Ratio in Predicting the Prognosis of Patients with Sepsis
摘要
Abstract
Objective To assess the value of neutrophil to lymphocyte ratio( NLR)in predicting the prognosis of patients with sepsis,and to explore the way to improving prediction efficiency of the prognosis in septic patients. Methods Two hundred and twenty - six patients with sepsis who were treated in ICU of the First Affiliated Hospital of Wenzhou Medical University from July 2012 to January 2015 were selected as research objects. According to the living condition during 28 days after the onset,these patients were divided into survival group(n = 167)and death group(n = 59). The blood samples were taken from peripheral blood of patients within 2 hours after admission. The blood lactate(Lac),procalcitonin(PCT),blood platelet count and white blood cell count(WBC)were measured and the differential white blood cell count was made,then NLR was calculated. The scores were measured according to APACHE Ⅱ with 24 hours after admission. Results There was no significant difference in the PCT,blood platelet count,WBC,and neutrophil count between the survival group and the death group(P >0. 05). There were significant differences in Lac,lymphocyte,NLR and APACHE Ⅱ score between the two groups( P <0. 05). The ROC area under the curve was 0. 693〔95% CI(0. 609,0. 777)〕and the cutoff value was 3. 05 mmol/ L predicted a 28 - day mortality by Lac of patients with sepsis with sensitivity of 75. 0% and specificity of 64. 2% . The ROC area under the curve was 0. 642〔95% CI(0. 556,0. 728)〕and the cutoff value was 14. 4 predicted a 28 - day mortality by NLR of patients with sepsis with sensitivity of 75. 0% and specificity of 51. 9%. While by APACHEⅡ score,the ROC area under the curve was 0. 742〔95% CI(0. 659,0. 825)〕and the cutoff was 16,the sensitivity was 71. 2% and the specificity was 66. 9% in predicting a 28 - day mortality of patients with sepsis. With a prediction of a 28 - day mortality by Lac + NLR + APACHEⅡ score of patients with sepsis,the ROC area under the curve was 0. 780〔95% CI(0. 702,0. 859)〕,and the cutoff was 0. 288 7,the sensitivity was 67. 3% and the specificity was 80. 0%. The ROC area under the curve of Lac + NLR + APACHEⅡ score predicted a 28 - day mortality of patients with sepsis was higher than that of NLR(Z = 2. 321,P < 0. 05). Conclusion It is difficult to evaluate the prognosis of septic patients with single marker,and NLR combined with Lac and APACHE Ⅱ score can improve the predicted efficiency of the prognosis of septic patients.关键词
脓毒症/中性白细胞/淋巴细胞计数/乳酸/急性生理学与慢性健康状况评分系统Ⅱ/预后Key words
Sepsis/Neutrophils/Lymphocyte count/Lactic acid/APACHE Ⅱ/Prognosis分类
医药卫生引用本文复制引用
陈洁,周小洁,王晓蓉,潘景业,黄跃跃,马继红,何杰,黄慧雅..中性粒细胞与淋巴细胞比值预测脓毒症患者预后的价值研究[J].中国全科医学,2017,20(5):533-537,5.基金项目
温州市科技局计划项目 （）
