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血小板与淋巴细胞比值与脓毒症患者病情及预后的相关性 被引量:5

Correlation between the ratio of platelet to lymphocyte and illness status and prognosis of patients with sepsis
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摘要 目的探讨血小板与淋巴细胞比值(PLR)与脓毒症患者病情严重程度及预后的相关性。方法回顾性分析142例脓毒症患者的临床资料,根据患者住院后28-d死亡情况分为死亡组(40例)和存活组(102例)。比较两组患者临床资料。采用Pearson相关分析PLR与脓毒症相关序贯器官衰竭评分(SOFA评分)和急性生理功能和慢性健康状况Ⅱ评分(APACHEⅡ评分)的相关性。采用多因素logistic回归分析影响脓毒症患者预后的危险因素。结果死亡组患者年龄、急性肾损伤发生率、血乳酸(Lac)、PLR、SOFA评分及APACHEⅡ评分均高于存活组(P<0.05)。Pearson相关分析显示,PLR与SOFA评分和APACHEⅡ评分呈正相关(r=0.600和0.549,P<0.05)。多因素logistic回归分析显示,高Lac水平、高PLR及高SOFA评分是脓毒症患者住院后28-d死亡的独立危险因素(P<0.05)。ROC曲线分析显示,PLR预测脓毒症患者早期死亡的AUC为0.885[95%CI(0.821~0.932),P=0.000],取最佳诊断界值240.8时,相应的灵敏度为80.00%,特异度为91.18%。结论 PLR升高是脓毒症患者早期死亡风险增加的独立危险因素,且可在一定程度上反映脓毒症疾病的严重程度。 Objective To investigate the correlation between the ratio of platelet to lymphocyte(PLR) and the illness status and prognosis of the patients with sepsis.Methods The clinical data of 142 patients with sepsis were retrospectively analyzed.According to the 28-day mortality of the patients after admission, the patients were divided into two groups of A(survival, 102 cases) and B(death in 28 days, 40 cases).The clinical data of two groups were compared.Pearson linear equation was used to analyze the correlation between PLR and sepsis-related sequential organ failure score(SOFA) and acute physiological function and chronic health status Ⅱ score(APACHE Ⅱ).The multivariate logistic regression equation was used to analyze the independent risk factors affecting the prognosis of the patients with sepsis.Results The age, incidence of acute kidney injury, blood lactic acid(Lac),PLR,SOFA score and APACHE Ⅱ score in group B were higher than those in group A(P<0.05).Pearson linear correlation analysis showed that PLR was positively correlated with SOFA and APACHE Ⅱ scores(r=0.600 and 0.549,P<0.05).Multivariate logistic regression analysis showed that high Lac level, high PLR and high SOFA score were the independent risk factors for the 28-day mortality of the patients after admission(P<0.05).The ROC curve showed that the AUC of PLR in early predicting the death of the patients with sepsis was 0.885 [95%CI(0.821-0.932),P=0.000].Taking 240.8 as the best diagnostic cut-off value, the corresponding sensitivity and specificity were 80.00% and 91.18%,respectively.Conclusion Elevated PLR is an independent risk factor for increased risk of early death in sepsis patients and can reflect the severity of sepsis to some extent.
作者 王平 谢枫 吴秋英 李辉 张义强 李永生 WANG Ping;XIE Feng;WU Qiuying(Department of ICU,Xinjiang Production and Construction Croup Hospital,Urumqi 830002,CHINA)
出处 《江苏医药》 CAS 2021年第3期264-267,273,共5页 Jiangsu Medical Journal
基金 新疆维吾尔自治区自然科学基金(2017D01C149)。
关键词 血小板与淋巴细胞比值 脓毒症 预后 Ratio of platelet to lymphocyte Sepsis Prognosis
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