中性-淋巴细胞比及简化肺栓塞严重指数在急性肺栓塞预后评估中的价值

Value of neutrophil-lymphocyte ratio and simplified pulmonary embolism severity index in the prognosis of acute pulmonary embolism

目的探讨中性-淋巴细胞比(neutrophil-lymphocyte ratio,NLR)及简化肺栓塞严重指数(simplified pulmonary embolism severity index,s PESI)与急性肺栓塞(acute pulmonary embolism,APE)患者住院死亡率的相关性。方法回顾性调查安徽医科大学第一附属医院2005年1月至2016年12月住院确诊的APE患者329例,根据患者住院期间预后将其分为幸存组及死亡组。分析APE预后相关因素:年龄、性别、s PESI、NLR、血小板-淋巴细胞比(platelet-lymphocyte ratio,PLR)、白细胞、心肌肌钙蛋白Ⅰ、脑钠肽及C-反应蛋白。结果存活组与死亡组比较,NLR、PLR、s PESI、白细胞、中性粒细胞、淋巴细胞差异显著(P<0.01)。多因素分析提示:s PESI(OR:2.595;95%CI:1.523-4.421)、NLR(OR:1.323;95%CI:1.098-1.595)是影响APE住院死亡率的独立危险因素。结论高NLR及s PESI与APE不良预后相关。

Objective To investigate the correlation between the neutrophil-lymphocyte ratio （ NLR） and the simplified pulmonary embolism severity index （ sPESI） with the prognosis of patients with acute pulmonary embolism （ APE） . Methods The clinical date of 329 patients with APE diagnosed in our hospital from January 2005 to De-cember 2016 were collected. According to the prognosis of hospital stay, they were divided into the survival group and the death group. The potential prognostic factors were analyzed such as age, gender, sPESI, NLR, platelet-lympho-cyte ratio （ PLR） , leukocyte, cardiac troponin I （ cTnI） , brain natriuretic peptide and C-reactive protein. Results The differences in NLR, PLR, sPESI, leukocyte, neutrophil and lymphocyte were significant between the survivor group and the death group （ P 〈0. 01 ） . Multivariate logistic regression analysis showed that sPESI （ OR： 2. 595;95% CI：1. 523-4. 421） and NLR （OR：1. 323;95% CI：1. 098-1. 595） were independent risk factors for pre-dicting in-hospital death of APE （P〈0. 05）. Conclusion Higher NLR and sPESI are associated with poor prognosis in patients with APE.