肺栓塞患者炎症指标与CT肺动脉阻塞指数的关系

Relations between inflammation biomarkers and CT pulmonary artery obstruction index in patients with pulmonary embolism

目的研究肺栓塞(PE)患者治疗前后白细胞计数(WBC)、中性粒细胞计数、淋巴细胞计数、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)和血清白细胞介素6(IL-6)水平与CT肺动脉阻塞指数(PAOI)的关系。方法前瞻性地纳入2015年6月至2017年2月广西壮族自治区人民医院、广西来宾市人民医院、广西河池市人民医院经CT肺动脉造影首次确诊的PE患者。治疗前24h内和治疗后第14天检测血清WBC、中性粒细胞计数、血小板计数、淋巴细胞计数、NLR、PLR和IL-6水平,探讨上述炎症指标治疗前后与PAOI及其变化率的关系。结果本研究共纳入47例PE患者。治疗前WBC、中性粒细胞计数、NLR和IL-6水平均与PAOI呈正相关性(r=0394、0430、0417、0547,P值均【005);治疗后IL-6水平与PAOI呈正相关性(r=0498,P=0000)。治疗前后PAOI变化率与治疗前NLR呈负相关性(r=-0352,P=0015),与治疗前淋巴细胞计数呈正相关性(r=0335,P=0021)。结论WBC、中性粒细胞计数、NLR和IL-6均与PAOI存在一定相关性。尤其是IL-6水平与PAOI相关性较高,可较好反应PE患者血栓栓塞严重程度。NLR越低,淋巴细胞计数越高,血栓溶解效果越显著,对于预测血栓溶解程度具有一定临床意义。

Objective To investigate the relationships between white blood cell(WBC),neutrophils,lymphocytes,neutrophil to lymphocyte ratio,platelet to lymphocyte ratio and serum IL-6 levels with pulmonary artery obstruction index(PAOI)in pulmonary embolism(PE)patients before and after short term treatment.Methods A prospective study was conducted on the PE patients first-diagnosed by computed tomographic pulmonary angiography in 3 hospitals from June 2015 to February 2017.The WBC,neutrophils,platelets,lymphocytes,neutrophil to lymphocyte radio(NLR),platelet to lymphocyte radio and serum IL-6 levels were examined pre-treatment and post-treatment on the 14th day.The relationships of these biomarkers with PAOI were analyzed pre-treatment and post-treatment on the 14th day.Results A total of 47 PE patients were enrolled from 3 hospitals.The PAOI was positively correlated with WBC,neutrophils,NLR,IL-6 pre­treatment(all P<0.05).The PAOI was positively correlated with IL-6 post-treatment(r=0.498,P=0.000).The varied rate of PAOI pre-and post-treatment were negatively correlated with NLR pre-treatment(r=-0.352,P=0.015),positively correlated with lymphocytes pre­treatment(r=0.335,P=0.021).Conclusions The WBC,neutrophils,NLR and IL-6 levels have correlations with PAOI,especially the IL-6 has closer correlation with PAOI,which could predict the degree of pulmonary artery obstruction better.The lower NLR and higher lymphocytes,the more significant of the embolus dissolution effect,they all have a certain clinical significance in predicting the degree of pulmonary embolus dissolution.