EGRIS评分联合外周血NLR对吉兰-巴雷综合征呼吸功能不全的预测价值

Predictive value of EGRIS combined with blood NLR for respiratory insufficiency in Guillain-Barre syndrome

目的探讨Erasmus GBS呼吸功能不全评分(EGRIS)联合外周血中性粒细胞/淋巴细胞比值(NLR)对吉兰-巴雷综合征(GBS)患者急性期发生呼吸功能不全的预测价值。方法回顾性收集2015年1月至2019年12月由徐州医科大学附属医院收治的GBS患者的临床资料,依据患者入院后一周内是否进行机械通气,分为机械通气组(MV组)和非机械通气组(Non-MV组),比较2组患者的EGRIS评分及NLR,运用受试者工作特征曲线(receiver operator characteristic curve,ROC曲线)计算曲线下面积(area under the curve,AUC),评价EGRIS评分及NLR对GBS患者急性期发生呼吸功能不全的预测价值,并运用多因素Logistic回归分析探究其他可能影响GBS患者急性期发生呼吸功能不全的危险因素。结果共收集299例GBS患者的资料,其中机械通气组52例,非机械通气组247例。多因素Logistic回归分析显示,EGRIS评分与NLR均可以预测GBS患者急性期呼吸功能不全的发生(OR值分别为2.006、1.166,P均<0.001)。ROC曲线显示,EGRIS评分、NLR以及二者联合预测GBS患者急性期呼吸功能不全的曲线下面积分别为0.866、0.906、0.933,灵敏度分别为82.7%、80.8%、94.2%,特异度分别为76.1%、87.9%、81.4%。结论 EGRIS评分和NLR对GBS患者急性期呼吸功能不全的发生均具有一定的预测价值,但两者联合比单独指标能够更加准确的预测GBS患者急性期发生呼吸功能不全的风险。

Objective To investigate the predictive value of erasmus GBS respiratory insufficiency score(EGRIS)combined with peripheral blood neutrophil to lymphocyte ratio(NLR) for respiratory insufficiency in patients with Guillain-Barre syndrome(GBS) in the acute stage. Methods Clinical data of GBS patients admitted to the affiliated hospital of Xuzhou medical university from January 2015 to December 2019 were collected retrospectively. Patients were divided into mechanical ventilation group and non-mechanical ventilation group according to whether mechanical ventilation was performed within one week after admission. EGRIS score and NLR were compared between the two groups. The predictive values of EGRIS score and NLR were evaluated using ROC curve. In addition, multivariate Logistic regression analysis was used to explore other risk factors affecting respiratory insufficiency in acute phase of GBS patients. Results The data of 299 patients with GBS were collected, including 52 patients in mechanical ventilation group and 247 patients in non-mechanical ventilation group. Multivariate Logistic regression analysis showed that both EGRIS score and NLR could predict the occurrence of respiratory insufficiency in patients with GBS in the acute stage(OR were 2.006 and 1.166, both P<0.001). The ROC curve showed that the area under the curve of EGRIS score, NLR and the combination of the two were 0.866, 0.906, and 0.933, the sensitivity were 82.7%, 80.8%, and 94.2%, and the specificity were 76.1%, 87.9%, and 81.4%. Conclusion Both EGRIS score and NLR have certain predictive value for occurrence of respiratory insufficiency in patients with GBS in the acute stage, but the combination of them is more reliable in the prediction of the risk of respiratory insufficiency in patients with GBS.