脓毒症患者早期中性粒细胞/淋巴细胞比值与预后的关系

Correlation of neutrophil to lymphocyte ratio in early stage with prognosis of septic patients

目的探讨早期中性粒细胞/淋巴细胞比值(NLR)与脓毒症患者预后的关系。方法入选96例脓毒症患者,根据预后分为死亡组及存活组,比较各组早期WBC计数、中性粒细胞比例、淋巴细胞比例、NLR、APACHEⅡ评分及PCT、CRP,并通过多因素logistic回归分析方法分析NLR与预后的关系。结果脓毒症患者ICU内总死亡率为47.6%,其中不同预后组住ICU内时间、机械通气时间、APACHEⅡ评分、中性粒细胞比例、淋巴细胞比例、NLR、血乳酸等组间差异有统计学意义(均P<0.05)。回归分析提示机械通气时间≥3.5d、APACHEⅡ评分≥21.5分、NLR≥10.8均为脓毒症死亡的独立危险因素。结论高NLR、APACHEⅡ评分与脓毒症患者不良预后密切相关,因此应重视NLR异常升高的脓毒症患者。

Objective To investigate the correlation of the early-stage neutrophil to lymphocyte ratio （NLR） with prognosis of septic patients. Methods The 96 septic patients were divided into death group and survival group according to the prognosis. And the early-stage white blood cell count, neutrophil ratio, lymphocyte ratio, neutrophil to lymphocyte ratio （NLR）, APACHE 11 score, PCT and CRP in different groups were compared. And the relationship between the neutrophil to lymphocyte ratio （NLR） and prognosis of the patients were investigated with multiple logistic regression analysis. Results The total mortality of septic patients was 47.6%. Significantly statistical difference in days stayed in ICU, the days needing mechanical ventilation, APACHE II score while enrolled in ICU, neutrophil ratio, lymphocyte ratio, NLR and serum lactate while enrolled in ICU were noticed between groups. And the multiple logistic regression analysis showed that the duration needing mechanical ventilation of ≥3.5d, APACHE II score of ≥21.5 and NLR of ≥ 10.8% were independent risk factors. Conclusion Higher NLR and APACHE II score are closely associated with the death of septic patients, hence, attention be payed to the septic patients with a extraordinally higher NLR.