NLR、PLR在高血脂症性急性胰腺炎诊断及病情评估中的价值

The value of NLR and PLR in diagnosis and evaluation of hyperlipidemia acute pancreatitis

目的探究中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)在高血脂症性急性胰腺炎(HLAP)诊断及病情评估中的价值。方法选取本院132例HLAP患者作为观察组,另选取同期66例胆源性、酒精性急性胰腺炎非HLAP患者作为对照组,66例健康体检者作为健康组,比较3组NLR、PLR、血脂指标[总胆固醇(TC)、三酰甘油(TG)]、炎性因子[C反应蛋白(CRP)、降钙素原(PCT)],分析NLR、PLR与血脂指标、炎性因子相关性,采用受试者工作特征(ROC)曲线评价NLR、PLR诊断价值,对比观察组不同病情程度患者NLR、PLR水平,分析NLR、PLR与HLAP病情程度的关系。结果观察组NLR、PLR、TC、TG、CRP、PCT高于对照组、健康组,对照组高于健康组,差异有统计学意义(P<0.05);Pearson相关性分析,NLR、PLR与TC、TG、CRP、PCT呈正相关(P<0.05);ROC曲线分析,NLR、PLR联合诊断AP的AUC为0.901,95%CI为0.858~0.934,敏感度为80.30%,特异度为92.42%,两者联合诊断HLAP的AUC为0.846,95%CI为0.788~0.893,敏感度为71.21%,特异度为83.33%,均优于两者单独诊断,差异有统计学意义(P<0.05);观察组重度患者NLR、PLR高于中度患者、轻度患者,中度患者高于轻度患者,差异有统计学意义(P<0.05);Spearman相关性分析,NLR、PLR与HLAP病情程度呈正相关(P<0.05)。结论 NLR、PLR联合检测在HLAP诊断与病情评估中具有较高临床价值。

Objective To explore the value of neutrophil-to-lymphocyte ratio(NLR)and plateletto-lymphocyte ratio(PLR)in the diagnosis and evaluation of hyperlipidemia acute pancreatitis(HLAP).Methods 132 HLAP patients from this Hospital were selected as the observation group,66 non-HLAP patients with biliary and alcoholic acute pancreatitis during the same period were selected as the control group,and 66 healthy subjects were selected as the healthy group. The NLR,PLR,blood lipid indexes[total cholesterol(TC),triacylglycerol(TG)],inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT)]in the three groups were compared. The correlation between NLR and PLR and blood lipid indexes and inflammatory factors were analyzed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of NLR and PLR. The NLR and PLR levels of patients with different disease levels in the observation group were compared,and the relationship between NLR,PLR and the disease level of HLAP was analyzed. Results The NLR,PLR,TC,TG,CRP and PCT in the observation group were higher than those in the control group and the healthy group,and the control group was higher than the healthy group,the difference was statistically significant(P<0.05). Pearson correlation analysis showed that NLR and PLR were positively correlated with TC,TG,CRP and PCT(P<0.05). The ROC curve analysis showed that the AUC of the combined diagnosis of AP by NLR and PLR was 0.901,95%CI was 0.858 to 0.934,sensitivity was 80.30%,and specificity was 92.42%. The AUC of the two combined diagnosis of HLAP was 0.846,the 95%CI was0.788-0.893,the sensitivity was 71.21%,and the specificity was 83.33%,which were better than the twoindependent diagnosis,the difference was statistically significant(P<0.05). The NLR and PLR of severe patients in the observation group were higher than those of moderate patients and mild patients,and the moderate patients were higher than the mild patients,the difference was statistically significant(P<0.05). Spearman correlation analysis showed that NLR,PLR and the severity of HLAP were positively correlated(P<0.05). Conclusion The combined detection of NLR and PLR has high clinical value in HLAP diagnosis and disease assessment.