首页|NLR、PLR和sPESI评分对急性肺栓塞患者30天死亡的预测价值

NLR、PLR和sPESI评分对急性肺栓塞患者30天死亡的预测价值

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目的 探讨中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)和简化版肺栓塞指数(simplified pulmonary embolism severity index,sPESI)评分对急性肺栓塞(acute pulmona-ry embolism,APE)患者30天死亡的预测价值.方法 回顾分析2017年1月~2021年12月首都医科大学宣武医院住院的291例APE患者的临床资料,收集入院时白细胞计数(white blood cell,WBC)、NLR、PLR、sPESI评分等指标.病例随访或电话随访其30天内死亡情况,根据预后分成死亡组和存活组,比较两组患者上述指标的区别.应用多因素Logistic回归分析APE患者30天死亡的独立危险因素,比较NLR、PLR及联合sPESI评分对死亡预测的受试者工作特征(receiver operating characteristic,ROC)曲线下面积的区别.结果 APE患者30天内死亡11例(3.78%),生存280例(96.22%).死亡组患者WBC、NLR、PLR和sPESI评分大于存活组(P<0.05);多因素Logistic回归分析显示,PLR、NLR和sPESI评分为APE患者30天死亡的独立危险因素(P<0.05).PLR 预测 APE 患者 30 天死亡的 ROC 曲线下面积(area under ROC curve,AUC)为 0.799(P=0.001),NLR 的 AUC 为0.827(P=0.001),sPESI评分的AUC为0.874(P=0.001),PLR、NLR与sPESI评分预测死亡的AUC比较,差异无统计学意义(P=0.181,0.340);NLR 联合 sPESI 评分的 AUC 为 0.925(P=0.001),大于 NLR 的 AUC(P=0.004).PLR 联合 sPESI 评分的AUC为0.901(P=0.001),大于PLR的AUC(P=0.002).结论 NLR、PLR和sPESI评分是APE患者30天死亡的独立危险因素,均对预后具有一定的评估价值.PLR、NLR分别联合sPESI评分对预后的评估价值大于单独应用PLR和NLR.
Predictive Value of NLR,PLR and sPESI Score for 30-day Mortality in Patients with Acute Pulmonary Embolism
Objective To investigate the predictive value of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and the simplified pulmonary embolism index(sPESI)score for 30-day death in patients with acute pulmonary embolism(APE).Methods The clinical data of 291 APE patients admitted to Xuanwu Hospital of Capital Medical University from January 2017 to December 2021 were retrospectively analyzed.White blood cell count(WBC),NLR,PLR,sPESI score,and other indicators were calculated at admission.The patients were followed up within 30 days and were divided into the death group and the survival group accord-ing to the prognosis.The differences in the above indexes between the two groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors for 30-day mortality in APE patients.The area under the receiver operating characteristic(ROC)curve of NLR,PLR,and combined sPESI scores in predicting mortality was compared.Results Among the APE patients,11 cases(3.78%)died and 280 cases(96.22%)survived within 30 days.The WBC,NLR,PLR,and sPESI score in the death group were sig-nificantly higher than those in the survival group(P<0.05).Multivariate Logistic regression analysis showed that PLR,NLR,and sPESI score were independent risk factors for 30-day mortality in APE patients(P<0.05).The area under ROC curve(AUC)of PLR in pre-dicting the 30-day death of APE patients was 0.799(P=0.001).The AUC of NLR was 0.827(P=0.001).The AUC of sPESI score was 0.874(P=0.001).There was no significant difference in the AUC of PLR,NLR,and sPESI score in predicting death(P=0.181,0.340);the AUC of NLR combined with sPESI score was 0.925(P=0.001),which was greater than that of NLR(P=0.004).The AUC of PLR combined with sPESI score was 0.901(P=0.001),which was greater than that of PLR(P=0.002).Conclusion NLR,PLR,and sPESI score are independent risk factors for 30-day mortality in APE patients,and all of them have certain prognostic values.The prognostic value of PLR and NLR combined with sPESI score was higher than that of PLR and NLR alone.

Acute pulmonary embolismNLRPLRsPESI scorePrognosis

韩英娜、王晶、何婧瑜、王长远

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100053 北京,首都医科大学宣武医院急诊科

急性肺栓塞 NLR PLR sPESI评分 预后

2024

医学研究杂志
中国医学科学院

医学研究杂志

CSTPCD
影响因子:0.702
ISSN:1673-548X
年,卷(期):2024.53(1)
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