中性粒细胞-淋巴细胞比值与新型冠状病毒肺炎患者预后的相关性研究

Correlation between neutrophil-lymphocyte ratio and prognosis of patients with corona virus disease 2019

目的探讨中性粒细胞-淋巴细胞比值(NLR)与新型冠状病毒肺炎(COVID-19)患者预后的相关性。方法回顾性分析2020年1至3月嘉兴市第一医院收治并康复出院的35例COVID-19患者的临床资料。根据治疗前NLR的中位数值,分为低NLR组(<3.67)和高NLR组(≥3.67),分别观察两组患者的临床特征、核酸转阴时间及住院时间。采用Kaplan-Meier法描绘生存曲线,Cox回归模型分析影响患者预后的危险因素。结果两组患者性别、年龄、流行病学史、治疗方案、激素使用情况、合并症比较差异均无统计学意义(均P>0.05)。Cox单因素分析发现中性粒细胞计数、NLR均为影响患者核酸转阴时间及住院时间的危险因素(均P<0.05);Cox多因素分析证实中性粒细胞计数、NLR均为影响患者核酸转阴时间及住院时间的独立危险因素(均P<0.01)。治疗前NLR越高(≥3.67)、中性粒细胞越低(<3.50×109/L)的患者核酸转阴时间及住院时间越长(均P<0.05)。结论NLR及中性粒细胞计数均可能是预测COVID-19患者预后的独立危险因素,NLR越高、中性粒细胞计数越低,患者预后越差。

Objective To explore the correlation between neutrophil-lymphocyte ratio(NLR)and prognosis of patients with corona virus disease 2019(COVID-19).Methods The clinical data of 35 patients with COVID-19 admitted to the Jiaxing First Hospital from January to March 2020 was retrospectively analyzed.Based on the median of NLR prior to treatment,the patients were divided into low NLR group(<3.67)and high NLR group(≥3.67).Clinical features,nucleic acid negative time and length of hospital stay of the two groups were compared.Kaplan-Meier method was used to analyze the survival of patients and Cox regression model was used to analyze the factors influencing the prognosis of COVID-19 patients.Results There were no significant differences in gender,age,epidemiological history,treatment plan,complications and hormone use between the two groups(all P>0.05).Cox univariate analysis showed that neutrophil count and NLR were the risk factors of nucleic acid negative time and length of hospital stay(all P<0.05),Cox multivariate analysis confirmed that neutrophil count and NLR were the independent risk factors of nucleic acid negative time and length of hospital stay(all P<0.01).Before treatment,the patients with higher NLR(≥3.67)and lower neutrophil(<3.50×109/L)had longer nucleic acid negative time and hospital stay(all P<0.05).Conclusion NLR and(or)neutrophil count are independent predictor of prognosis of COVID-19 patients,and higher NLR or lower neutrophil count might lead to poorer prognosis.