中性粒细胞与淋巴细胞比值对急性胰腺炎并发急性呼吸窘迫综合征的预测价值

Predictive value of neutrophil-lymphocyte ratio and WBC in acute pancreatitis complicated with ARDS

摘要:

目的 探讨中性粒细胞与淋巴细胞比值（NLR）在急性胰腺炎（AP）并发急性呼吸窘迫综合征（ARDS）中的预测价值。方法 回顾性分析2015年10月—2018年2月山西省人民医院收治符合入组标准的93例确诊为急性胰腺炎（AP）患者的临床资料。根据2012年ARDS柏林标准，按是否发生ARDS分为ARDS阳性组和ARDS阴性组，观察两组患者临床指标、生化指标及NLR。采用受试者操作特征（ROC）曲线和Logistic回归分析评估NLR、白细胞计数（WBC）对AP并发ARDS的预测价值。结果 93例符合标准的患者，其中ARDS阳性组18例，ARDS阴性组75例。两组患者WBC、中性粒细胞计数（ANC）、淋巴细胞计数（ALC）、NLR、淋巴细胞与单核细胞比值（LMR）及心率的比较，差异有统计学意义（P?<0.05）。ROC曲线下最佳临界值为：NLR 15.43、WBC 17.05×109/L，ROC曲线下面积分别为NLR 0.948、WBC 0.869，联合检测为0.955。NLR和WBC串联检测时预测AP发生ARDS的特异性最高，为100%；NLR和WBC并联检测时预测AP发生ARDS的敏感性最高为是88.9%（误诊率11.1%）。结论 NLR、WBC与AP并发ARDS密切相关，且两者联合检测对早期预测AP并发ARDS的特异性和敏感性最高。

Abstract:

Objective To explore the predictive value of neutrophil-lymphocyte ratio (NLR) and WBC in severe acute pancreatitis (SAP) complicated with ARDS. Methods The clinical data of 93 patients of acute pancreatitis (AP) who were admitted to Shanxi Provincial People’s Hospital during October 2015 to February 2018 were analyzed retrospectively. According to ARDS Berlin criteria in 2012, the patients was divided into ARDS group and ARDS-negative group. The clinical indicators, biochemical indicators and NLR of the two groups were observed. The t-test and chi-square test were used to compare the NLR and other indicators between the two groups. The receiver operating characteristic (ROC) curve and logistic regression analysis were used to evaluate the predictive value of NLR for AP complicated with ARDS. Results Of the 93 patients who met the criteria, 18 were in the ARDS-positive group and 75 in the ARDS-negative group. There were significant differences in WBC, absolute neutrophil count (ANC), absolute lymphocyte count (ALC), NLR, lymphocyte-to-monocyte ratio (LMR), and heart rate between the two groups (P?