中性粒细胞/淋巴细胞比值在急性复杂性阑尾炎诊断中的临床价值

Clinical Value of Neutrophil-to-lymphocyte Ratio in the Diagnosis of Complicated Acute Appendicitis

目的:研究急性阑尾炎患者术前的中性粒细胞/淋巴细胞比值(NLR)对急性复杂性阑尾炎的预测价值。方法:回顾性分析2017年12月-2019年8月笔者所在医院住院的188例行手术治疗的急性阑尾炎患者临床资料,根据病理结果分为急性非复杂性阑尾炎(uncomplicated acute appendicitis,UAA)组(n=122)及急性复杂性阑尾炎(complicated acute appendicitis,CAA)组(n=66),比较两组患者的血常规结果。应用ROC曲线,计算曲线下面积(AUC)评价NLR对CAA的预测价值。结果:CAA组的NLR、白细胞计数、中性粒细胞计数水平分别为16.54(12.15,25.91)、(14.68±5.62)×10^9/L、(13.05±5.21)×10^9/L,高于UAA组的6.32(2.80,9.99)、(11.77±4.78)×10^9/L、(9.38±4.73)×10^9/L,CAA组的淋巴细胞计数水平为0.72(0.46,1.11)×10^9/L,低于UAA组的1.53(1.16,2.04)×10^9/L,差异均有统计学意义(P<0.05)。ROC曲线示NLR为 9.74是预测复杂性阑尾炎的最佳界值,敏感度为84.8%,特异度为75.4%。结论:NLR有助于评估急性阑尾炎炎症的严重程度。

Objective:To study the predictive value of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with complicated acute appendicitis.Method:The records of a total of 188 patients who underwent curative surgery for acute appendicitis (AA) from December 2017 to August 2019 were retrospectively investigated.The patients were divided into uncomplicated acute appendicitis (UAA) group (n=122) and complicated acute appendicitis (CAA) group (n=66) based on pathological reports.The preoperative blood routine examination results of the groups were compared.The ROC curve was used to calculate the area under the curve(AUC) to evaluate the predictive value of NLR to CAA.Result:The levels of NLR,white blood cell count,neutrophil count in the CAA group were 16.54 (12.15,25.91),(14.68±5.62)×10^9/L,(13.05±5.21)×10^9/L,higher than those in the UAA group of 6.32 (2.80,9.99),(11.77±4.78)×10^9/L,(9.38±4.73)×10^9/L,and the lymphocyte level of the CAA group was 0.72 (0.46,1.11)×10^9/L,lower than 1.53 (1.16,2.04)×10^9/L of the UAA group,the differences were statistically significant (P<0.05).The ROC curve showed that a NLR of 9.74 was cut-off value for complicated appendicitis with the sensitivity of 84.8% and specificity of 75.4%.Conclusion:The study demonstrates that NLR can be useful to evaluate the severity of acute appendicitis.