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血小板计数/淋巴细胞计数比值在流感病毒性脓毒症早期筛查及预后预测中的应用价值OACSTPCD

Value of platelet to lymphocyte ratio in early screening and prognosis prediction of influenza viral sepsis

中文摘要英文摘要

背景 流感病毒性脓毒症患者早期临床表现缺乏特异性,短期内可出现病情快速进展,血小板计数/淋巴细胞计数比值(platelet to lymphocyte ratio,PLR)应用于多种疾病的早期筛查和预后预测,目前缺少PLR在流感病毒性脓毒症中的研究.目的 探讨PLR在流感病毒性脓毒症早期筛查及预后预测中的应用价值.方法 选择 2016年 1月—2023年 3月解放军总医院第五医学中心收治的流感患者 109例,分为流感普通组(59例)和流感病毒性脓毒症组(50例),分析PLR对流感病毒性脓毒症发生的预测价值及对预后的影响.结果 流感病毒性脓毒症组的淋巴细胞计数、PaO2/FiO2 低于流感普通组,年龄、PLR、D-二聚体显著高于流感普通组(P<0.05).Logistic回归分析显示PLR是流感病毒性脓毒症发生的独立预测因素(OR=1.010,95%CI:1.002~1.018,P<0.05),ROC曲线显示PLR预测流感病毒性脓毒症发生的曲线下面积最大(0.755),敏感度最高(0.820),最佳截断值为 123.79.脓毒症患者治疗 5d后高PLR组(≥123.79)较低PLR组患者住院时间更长[M(IQR):13.50(8.75~19.75)d vs 8.00(7.00~10.00)d,P=0.016],死亡率更高(28.57%vs 4.00%,P=0.047).结论 PLR是流感病毒性脓毒症发生的独立预测因素,治疗后高PLR的脓毒症患者住院时间更长、死亡率更高,PLR可用于流感病毒性脓毒症的早期筛查及预后判断.

Background The early clinical manifestations of patients with influenza viral sepsis lack specificity,and rapid progression may occur in short time.PLR is used in the early screening and prognosis prediction of a variety of diseases,but there is few research in influenza virus sepsis.Objective To investigate the application value of platelet/lymphocyte ratio(PLR)in early screening and prognosis of influenza virus sepsis.Methods Totally 109 patients were selected in the Fifth Medical Center of Chinese PLA General Hospital from January 2016 to March 2023.The patients were divided into influenza ordinary group(n=59)and influenza virus sepsis group(n=50).General information and laboratory tests within 24 hours of admission were compared between the two groups.The predictive value of PLR for influenza virus sepsis and its effect on prognosis were analyzed.Results The lymphocyte count and PaO2/FiO2 in patients with influenza virus sepsis were significantly lower than those in common influenza group,while age,PLR and D-dimer were significantly higher than those in the common group(P<0.05).Logistic regression analysis showed that PLR was an independent predictor of influenza viral sepsis(OR=1.010,95%CI:1.002-1.018,P<0.05).ROC curve showed that PLR had the largest area under the curve(0.755),the highest sensitivity(0.820)and the cut-off value was 123.79.Patients with influenza sepsis in the high PLR group(≥123.79)after 5 days of treatment had longer hospital stay(M[IQR]:13.50[8.75-19.75]days vs 8.00[7.00-10.00]days,P=0.016),and higher mortality(28.57%vs 4.00%,P=0.011).Conclusion PLR is an independent predictor of influenza virus sepsis.Patients with a high level of PLR after treatment have a long hospital stay and a high mortality rate.PLR can be used for early screening and prognosis of influenza virus sepsis.

王乐霄;车霄;黄锐;徐哲;王福生

解放军医学院,北京 100853||解放军总医院第五医学中心感染病医学部,北京 100039解放军总医院第五医学中心感染病医学部,北京 100039

临床医学

血小板计数/淋巴细胞计数比值流感病毒脓毒症早期筛查预后

platelet to lymphocyte ratioinfluenzasepsisearly screeningprognosis

《解放军医学院学报》 2024 (006)

578-583 / 6

国家重点研发计划(2022YFC2304404)

10.12435/j.issn.2095-5227.2024.089

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