乳酸联合NLR评估脓毒症预后的价值研究

The value of lactic acid combined with neutrophil to lymphocyte ratio in evaluating the prognosis of sepsis

目的:探讨乳酸联合中性粒细胞与淋巴细胞比值(NLR)在预测脓毒症患儿预后中的意义。方法:依据28 d预后情况将某医院ICU收治的146例脓毒症患儿分为存活组(105例)和病死组(41例),收集各组研究对象入院72 h的白细胞计数(WBC)、中性粒细胞计数(NEU)、淋巴细胞计数(LYM)、CRP和乳酸,计算出NLR。绘制受试者工作特征曲线(ROC),评估各指标在预测脓毒症患儿预后中的价值。结果:与存活组相比,病死组患儿NEU、NLR、CRP、乳酸均升高,LYM明显降低,差异有统计学意义(P<0.05),两组WBC差异无统计学意义(P>0.05)。ROC曲线分析显示,乳酸和NLR预测脓毒症预后的曲线下面积(AUC)分别为0.756、0.834,敏感度分别为60.98%、75.61%,特异度分别为75.24%、79.05%,乳酸与NLR联合变量预测脓毒症预后的曲线下面积(AUC)为0.865,敏感度和特异度分别为80.49%、76.19%。结论:乳酸可预测脓毒症患儿预后,与NLR联合后可提高敏感度。

Objective:To investigate the significance of lactate combined with neutrophil-to-lymphocyte ratio(NLR)in predicting the prognosis of children with sepsis.Methods:According to the 28-day prognosis,146 children with sepsis who were admitted to the ICU in hospital were divided into a survival group(105 cases)and a death group(41 cases).The NLR was calculated from the white blood cell count(WBC),neutrophil count(NEU),lymphocyte count(LYM),CRP and lactate of the subjects at admission 72 hours.The receiver operating characteristic(ROC)curve was drawn to evaluate the value of each index in predicting the prognosis of children with sepsis.Results:Compared with the survival group,NEU,NLR,CRP,and lactate were all increased in the death group,and LYM was significantly decreased,and the difference was statistically significant(P<0.05).There was no significant difference in WBC between the two groups(P>0.05).ROC curve analysis showed that the area under the curve(AUC)of lactate and NLR in predicting the prognosis of sepsis were 0.756 and 0.834,respectively,the sensitivity was 60.98%,75.61%,and the specificity was 75.24%and 79.05%,respectively.The combination of lactate and NLR The area under the curve(AUC)of the variable predicting the prognosis of sepsis was 0.865,and the sensitivity and specificity were 80.49%and 76.19%,respectively.Conclusion:Lactic acid can predict the prognosis of children with sepsis,and the sensitivity can be improved when combined with NLR.