NLR、PLR、hs-CRP与毒蛇咬伤程度的相关性研究

Correlation between NLR,PLR,HS-CRP and venomous snake bite degree

目的分析NLR、PLR、hs-CRP与毒蛇咬伤严重程度的相关性,评估NLR、PLR、hs-CRP在毒蛇咬伤预后判断中的应用价值。方法选取2020年3月~2021年7月我院救治的毒蛇咬伤患者100例为蛇伤组,同期选取基线资料与毒蛇咬伤组1∶1匹配的健康体检者为健康组。检测所有纳入对象的NLR、PLR及hs-CRP水平。同时将蛇伤组的患者根据蛇咬伤程度分为重度组(12例)、中度组(25例)、轻度组(63例),采用Spearman分析NLR、PLR、hs-CRP水平与毒蛇咬伤严重程度的相关性。根据治疗5 d后的症状及体征、辅助检查结果将患者分为预后良好组和不良组,ROC分析两组的NLR、PLR、hs-CRP水平对蛇伤患者预后的判断价值。结果蛇伤组的NLR和hs-CRP水平高于健康组,PLR低于健康组,差异均有统计学意义(均P<0.05)。蛇伤组的NLR和hs-CRP水平与蛇伤严重程度呈正相关(r=0.577,P<0.05;r=0.339,P<0.05),与PLR水平呈负相关(r=-0.646,P<0.05)。经ROC分析发现,NLR、PLR、hs-CRP区分蛇伤预后情况的阈值分别为4.69%、69.48%、4.56%,灵敏度分别为83.3%、57.3%、94.4%,特异度分别为91.5%、83.3%、52.4%,曲线下面积(AUC)分别为0.887、0.741、0.788。结论NLR、PLR、hs-CRP水平可一定程度上反映毒蛇咬伤的严重度,可用于蛇伤患者预后的辅助判断。

Objective To analyze the correlation between NLR,PLR,HS-CRP and the severity of snakebite,and evaluate the application value of NLR,PLR,HS-CRP in the prognosis of snakebite.Methods From March 2020 to December 2021,100 patients with snakebite in our hospital were selected as the research object(snakebite group),and healthy subjects(healthy group)with 1∶1 matching baseline data and snakebite group were selected as the control group.NLR,PLR and HS-CRP of the included subjects were collected.According to the severity of snakebite,they were divided into severe group(12 cases),moderate group(25 cases)and mild group(63 cases).Spearman analysis was conducted to analyze the correlation between NLR,PLR,HS-CRP levels and severity of snakebite.According to the symptoms and signs after 5 days of treatment and the results of auxiliary examination,the patients were divided into good and bad groups.ROC analysis of NLR,PLR and Hs-CRP levels between the two groups for the prognosis of snake injury patients.Results The levels of NLR and Hs-CRP in snake-injured group were higher than those in healthy group,while PLR was lower than that in healthy group(P<0.05).The levels of NLR and Hs-CRP were positively correlated with the severity of snake injury(r=0.577,P<0.05;r=0.339,P<0.05),was negatively correlated with PLR level(r=-0.646,P<0.05).ROC analysis showed that the thresholds of NLR,PLR and HS-CRP were 4.69,69.48 and 4.56,respectively.The sensitivities were 83.3%,57.3 and 94.4%,respectively.The specificity was 91.5%,83.3%and 52.4%,respectively.Areas under the curve(AUC)are 0.887,0.741 and 0.788.Conclusion The levels of NLR,PLR and HS-CRP can reflect the severity of snakebite to some extent,and can be complementarily used to judge the prognosis of snakebite patients.