三种指标与病毒性脑炎患者病情严重程度及预后的相关性研究

Relationship between three indexes with the severity and prognosis of viral encephalitis patients

目的探讨红细胞分布宽度、中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、淋巴细胞/单核细胞比值(lymphocyte-to-monocyte ratio,LMR)与病毒性脑炎患者病情严重程度及预后的相关性。方法选取2018年9月至2020年9月湖南中医药大学第二附属医院收治的120例病毒性脑炎患者为观察组,另择同期在湖南中医药大学第二附属医院进行健康体检的100例健康受试者为对照组。根据病情严重程度将观察组患者分为轻症组(88例)和重症组(32例)。根据预后不同将观察组患者分为预后不良组(21例)和预后良好组(99例)。比较分析对照组与观察组、轻症组与重症组、预后不良组与预后良好组患者的红细胞分布宽度标准差(standard deviation of red blood cell distribution width,RDW-SD)、NLR、LMR水平。分析RDW-SD、NLR、LMR对病毒性脑炎患者预后不良的预测价值。结果观察组患者的RDW-SD、NLR水平均显著高于对照组(P<0.05),LMR水平显著低于对照组(P<0.05)。重症组患者的RDW-SD、NLR水平均显著高于轻症组(P<0.05),LMR水平显著低于轻症组(P<0.05)。预后不良组患者的RDW-SD、NLR水平均显著高于预后良好组(P<0.05),LMR水平显著低于预后良好组(P<0.05)。RDW-SD、NLR和LMR预测病毒性脑炎患者预后不良的曲线下面积分别为0.829、0.901和0.890,敏感度分别为77.32%、76.54%和78.53%,特异度分别为78.63%、86.83%和86.88%。结论病情严重程度及预后不同的病毒性脑炎患者的RDW-SD、NLR、LMR水平存在明显差异,且RDW-SD、NLR、LMR对病毒性脑炎患者的预后不良具有一定预测价值。

Objective To investigate the relationship between RDW,NLR,LMR with the severity and prognosis of viral encephalitis patients.Method 80 patients with viral encephalitis treated in our hospital from September 2018 to September 2020 were taken as the observation group,and 100 healthy volunteers who underwent physical examination in our hospital in the same period were taken as the control group.The patients in the observation group were divided into mild group(88 cases)and severe group(32 cases)according to the severity.The patients in the observation group were divided into poor prognosis group(21 cases)and good prognosis group(99 cases)according to different prognosis.RDW-SD,NLR and LMR levels of patients in control group and observation group,mild group and severe group,poor prognosis group and good prognosis group were compared and analyzed.To analyze the predictive value of RDW-SD,NLR and LMR for poor prognosis.Result The levels of RDW-SD and NLR in observation group were significantly higher than those in control group(P<0.05),and the LMR was significantly lower than that in control group(P<0.05).The levels of RDW-SD and NLR in severe group were significantly higher than those in mild group(P<0.05),and the LMR was significantly lower than that in mild group(P<0.05).The levels of RDW-SD and NLR in poor prognosis group were significantly higher than those in good prognosis group(P<0.05),and the LMR was significantly lower than that in good prognosis group(P<0.05).The area under the curve of RDW-SD,NLR and LMR for predicting poor prognosis of viral encephalitis patients were 0.829,0.901 and 0.890,with sensitivity of 77.32%,76.54%and 78.53%,and specificity of 78.63%,86.83%and 86.88%.Conclusion There are significant differences in the levels of RDW-SD,NLR and LMR in patients with different severity and prognosis.RDW-SD,NLR and LMR have certain predictive value for poor prognosis of viral encephalitis patients.