NLR和LMR及NMP在急性胰腺炎严重程度评估中的价值研究

Study on the value of NLR, LMR and NMP in the assessment of the severity of acute pancreatitis

目的探究新型炎症指标NLR、LMR及NMP在急性胰腺炎(AP)严重程度评估中的价值。方法选取2012年5月至2019年2月于本院收治的且明确诊断为AP患者113例作为研究对象,按照AP诊断结果分为MAP组(n=38)、MSAP组(n=37)及SAP组(n=38)。记录患者入院首次白细胞(WBC)、血小板(PLT)、白蛋白(ALB)、C-反应蛋白(CRP)和淀粉酶(AMY)等指标,并依据中性粒细胞/淋巴细胞(NLR)=NEU/LYM、淋巴细胞/单核细胞(LMR)=LYM/MON及中性粒细胞×单核细胞(NMP)=NEU×MON公式计算NLR、LMR和NMP等炎症指标。采用受试者诊断曲线评价上述炎症指标对于预测中重度AP发生的诊断性能。结果3组WBC、PLT、ALB、CRP、AMY、NLR、LMR、NMP及住院期间死亡率等指标比较差异有统计学意义(P<0.05)。ROC曲线表明单一指标NMP鉴别中重度AP发生的诊断价值最高,而联合检测诊断曲线下面积高达0.92。结论新型炎症指标NLR、LMR和NMP在不同严重程度AP患者中存在差异,且联合检测对于预测中重度AP发生具有较高的诊断价值。

Objective To explore the value of new inflammatory markers NLR,LMR and NMP in the assessment of severity of acute pancreatitis(AP).Methods 113 patients with AP who were admitted to our hospital from May 2012 to February 2019 with clear diagnosis were selected as the research subjects.According to the diagnosis results of AP,they were divided into MAP group(n=38),MSAP group(n=37)and SAP group(n=38).The indicators of WBC,PLT,ALB,CRP and AMY were recorded for the first time after hospitalization,and inflammatory indicators such as NLR,LMR and NMP were calculated according to the formulas of NLR=NEU/LYM,LMR=LYM/MON and NMP=NEU×MON.Used the receiver’s diagnostic curve to evaluate the diagnostic performance of the above-mentioned inflammatory indicators in predicting the occurrence of moderate to severe AP.Results There was statistically significant difference in WBC,PLT,ALB,CRP,AMY,NLR,LMR,NMP and mortality during hospitalization among the three groups(P<0.05).The ROC curve showed that single index NMP has the highest diagnostic value in identifying moderate to severe AP,while the area under the combined detection curve is as high as 0.92.Conclusion The new inflammatory indicators NLR,LMR and NMP are different in patients with AP of different severity,and combined detection has high diagnostic value for predicting the occurrence of moderate to severe AP.