目的 探讨空腹血糖与淋巴细胞比值(glucose-to-lymphocyte ratio,GLR)对急性胰腺炎(acute pancreatitis,AP)并发持续脏器衰竭(persistent organ failure,POF)的早期预测价值.方法 收集2015年1月～2020年12月扬州大学附属医院消化内科/胰腺中心收治的677例AP患者,其中602例患者未发生POF(非POF组),77例患者并发POF(POF组).收集患者的一般资料及入院24h以内的实验室指标,采用Logistic回归分析探讨AP并发POF的危险因素;绘制受试者工作特征(receiver oper-ating characteristic,ROC)曲线,评估GLR、外周血中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、血小板计数与淋巴细胞计数比值(platelet-to-lymphocyte ratio,PLR)、CT 严重程度指数(computed tomography severity index,CTSI)、Ranon评分对AP并发POF的早期预测效能.结果 POF组患者GLR、NLR、PLR、CTSI评分、Ranson评分显著高于非POF组(P＜0.05),GLR为AP并发POF的独立危险因素.在最佳截断值为0.76时,GLR预测AP并发POF的曲线下面积(area under the curve,AUC)为0.745,敏感度及特异性分别为75.47％和59.80％.GLR预测AP并发POF的AUC优于PLR(z=2.868,P=0.004),与 NLR、CTSI 评分相当(z=1.304,P=0.183;z=0.538,P=0.588),而相较 Ranson 评分预测效能差(z=2.973,P=0.001).结论 GLR为AP并发POF的独立危险因素,可作为一种的用于预测AP患者早期发生POF的新型血液学指标.
Early Predictive Value of Fasting Glucose-to-Lymphocyte Ratio for Persistent Organ Failure in Acute Pancreatitis
Objective To investigate the early predictive value of fasting glucose-to-lymphocyte ratio(GLR)in acute pancreati-tis(AP)complicated by persistent organ failure(POF).Methods A total of 677 patients with AP admitted to the Department of Gastro-enterology/Pancreatic Center,Affiliated Hospital of Yangzhou University from January 2015 to December 2020 were collected,of which 602 patients did not have POF(non-POF group)and 77 patients had concurrent POF(POF group).The general data and laboratory in-dicators within 24hours of admission were collected,and Logistic regression analysis was used to explore the risk factors of AP complicated with POF;receiver operating characteristic(ROC)curves were plotted to assess the early prediction efficiency of GLR,neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),computed tomography severity index(CTSI)and Ranson scores in pre-dicting AP complicated with POF.Results GLR,NLR,PLR,CTSI score,and Ranson score were significantly higher in the POF group than those in the non-POF group(P＜0.05),and GLR was an independent risk factor for AP complicated with POF.At an optimal cut-off value of 0.76,the area under the curve(AUC)of GLR for predicting AP complicated with POF was 0.745,with the sensitivity of 75.47％and the specificity of 59.80％.The AUC of GLR predicted AP complicated with POF was better than PLR(z=2.868,P=0.004),and was comparable to NLR and CTSI scores(z=1.304,P=0.183;z=0.538,P=0.588),and the predictive efficacy was worse compared with Ranson score(z=2.973,P=0.001).Conclusion GLR is an independent risk factor for AP complicated with POF and can be used as a better novel hematological indicator for predicting the early occurrence of POF in AP patients.
Fasting glucoseLymphocyteAcute pancreatitisPersistent organ failure
万方数据
维普
