外周血中性粒细胞计数与淋巴细胞和血小板比值对老年脓毒症患者28天死亡的预测价值
Predictive value of the ratio of peripheral blood neutrophil to lymphocyte and platelet for 28 day death in elderly patients with sepsis
王洪锦 1陶武 1聂诗雨 1刘秋宇 1王念1
作者信息
- 1. 402160 重庆,重庆医科大学附属永川医院重症医学科
- 折叠
摘要
目的 探讨外周血中性粒细胞计数与淋巴细胞和血小板比值(N/LPR)对老年脓毒症患者28 d死亡的预测价值.方法 根据入院28 d是否死亡将161例脓毒症患者分为生存组(108例)和死亡组(53例),收集其一般临床资料、入院24 h内的外周血中性粒细胞(NEU)、淋巴细胞(LYM)、PLT计数及N/LPR、NLR并分组进行比较.相关因素分析采用多因素logistic回归分析.采用受试者工作特征(ROC)曲线评价各指标对老年脓毒症患者预后的预测价值.结果 生存组外周血LYM、PLT计数均显著高于死亡组,而女性患者比例、急性生理学和慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分、序贯器官衰竭评估(SOFA)评分、NEU、NLR、N/LPR均显著低于死亡组(P＜0.05).多因素logistic回归分析结果显示,N/LPR、NLR降低是老年脓毒症患者28 d内死亡的独立危险因素(P＜0.05).ROC曲线分析结果显示,当N/LPR最佳截断值为18.5时,对应敏感度及特异度分别高于当NLR最佳截断值为21.73时对应的敏感度和特异度,且N/LRP的预测价值优于NLR.结论 N/LPR是老年脓毒症患者28d死亡的独立危险因素,其预测价值优于NLR.
Abstract
Objective To investigate the value of peripheral blood neutrophil to lymphocyte and platelet ratio(N/LPR)in predicting 28 d death in elderly patients with sepsis.Methods A total of 161 patients with sepsis were divided into survival group(108 cases)and death group(53 cases)according to whether they died within 28 d.General clinical data,peripheral blood neutrophil(NEU),lymphocyte(LYM),PLT count,N/LPR,NLR within 24h after admission were collected from all patients and were grouped for comparison.The correlation factors were analyzed by multivariate logistic regression analysis.Receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of each indicator in elderly sepsis patients.Results The counts of LYM and PLT in peripheral blood in survival group were significantly higher than those in death group,while the proportion of female patients,acute physiology and chronic health status scoring system Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,NEU,NLR and N/LPR were significantly lower than those in death group(P＜0.05).Multivariate logistic regression analysis showed that decreased N/LPR and NLR were independent risk factors for death in elderly sepsis patients within 28 d(P＜0.05).ROC curve analysis results showed that when the optimal cut-off value of N/LPR was 18.5,its sensitivity and specificity were higher than those when the optimal cut-off value of NLR was 21.73,and its prediction value was better than that of NLR.Conclusion N/LPR is an independent risk factor for 28 d death in elderly patients with sepsis,and its predictive value is better than NLR.
关键词
老年脓毒症/28天死亡率/中性粒细胞与淋巴细胞和血小板比值/中性粒细胞与淋巴细胞比值/血小板计数Key words
Elderly patients with sepsis/28 day mortality/Neutrophils to lymphocytes and platelets ratio/Neutrophil to lymphocyte ratio/Platelet count引用本文复制引用
基金项目
重庆市科卫联合医学科研项目(2020FYYX006)
出版年
2024
NETL
NSTL
万方数据