摘要
目的研究中性粒细胞，淋巴细胞比值（neutrophil／lymphocyteratio，NLR）对脓毒症患者病情严重程度及预后的评估和预测价值，并探讨影响脓毒症患者预后的相关因素。方法收集2016年5月-2017年7月徐州医科大学附属医院急诊ICU及综合ICU的脓毒症患者205例，根据病情严重程度分为脓毒症组（n=74）和脓毒性休克组（n=131）；根据28d生存情况分为生存组（n=93）和死亡组（n=112）。比较不同组间患者的一般资料、入院ICU24h内相关实验室检验结果、急性生理与慢性健康评分（acutephysiologyandchronichealthevaluation，APACHEII评分）和序贯器官衰竭评分（sequentialorganfailureassessment，SOFA评分）等。采用ROC曲线、相关性分析、Logistic回归对不同组间患者的相关数据进行统计分析。结果脓毒性休克组患者的NLR值（25．95±14．70）明显高于脓毒症组（13．14±9．19）；死亡组患者的NLR值（25．75±15．11）明显高于生存组（15．99±11．34），差异均有统计学意义（P=0．000）。NLR值预测脓毒症休克的ROC曲线下面积为0．801，预测28d死亡率的ROC曲线下面积为0．721。NLR值与SOFA评分呈正相关，相关系数为0．422（P=0．000）。年龄、NLR、SOFA评分、乳酸（LAC）是脓毒症患者28d死亡率的独立危险因素。结论NLR值是评估脓毒症患者病情严重程度、预测预后的良好的指标。年龄、NLR、SOFA评分、LAC是脓毒症患者28d死亡率的独立危险因素。
Objective To investigate the value of neutrophil / lymphocyte ratio （NLR） in evaluating and predicting the severity and prognosis of sepsis, and to explore the related factors affecting the prognosis of sepsis. Methods 205 consecutive patients with sepsis admitted to emergency ICU and ICU in the Affiliated Hospital of Xuzhou Medical University, from May 2016 to July 2017, were collected. According to the severity, the patients were divided into sepsis group （n=74） and septic shock group （n=131）; according to the 28-day survival, the patients were divided into survival group （n=93） and death group （n=112）. The general clinical data, laboratory test results within 24 hours, acute physiology and chronic health evaluation （APACHE II score） and sequential organ failure assessment （SOFA score） of patients in different groups were compared. The data of patients in different groups were analyzed by ROC curve, correlation analysis and logistic regression. Results The NLR value of the patients in septic shock group （25.95±14.70） was significantly higher than that in sepsis group （13.14±9.19）, and the difference was statistically significant （P= 0.000）. The NLR value of the patients in the death group （25.75 ± 15.11） was significantly higher than that in the survival group （15.99± 11.34）, and the difference was statistically significant （P=0.000）. The area under the ROC curve for predicting septic shock was 0.801, and the area under the ROC curve for predicting the mortality rate of 28 days was 0.721. The NLR value was positively correlated with the SOFA score, and the correlation coefficient was 0.422 （P= 0.0013）. Age, NLR value, SOFA score, and lactic acid level were independent risk factors for 28-day mortality in patients with sepsis. Conclusion NLR is a good index to predict the severity and prognosis of sepsis. Age, NLR, SOFA
作者
张培杰
许铁
ZHANG Pei-jie;XU Tie(Emergency Center,the Affiliated Hospital of Xuzhou Medical University,221002,China)
出处
《中国急救复苏与灾害医学杂志》
2018年第7期642-647,共6页
China Journal of Emergency Resuscitation and Disaster Medicine
作者简介
通信作者：许铁，Email：xutie889@163．com
