中性粒细胞/淋巴细胞比值对脓毒症患者预后的价值分析

The value of neutrophil/lymphocyte ratio in prognosis of patients with sepsis

目的:探讨中性粒细胞/淋巴细胞比值(NLR)对脓毒症患者预后的预测价值。方法:选取2019年5月—2021年5月深圳市宝安区中心医院收治的60例脓毒症患者选为研究对象,根据发病后4周的生存情况分为生存组(n=47)、死亡组(n=13)。回顾性分析对比两组患者入院后病情严重程度、实验室相关指标(白细胞计数、血小板计数、血乳酸水平、NLR)及临床相关指标[急性生理学及慢性健康状况评分系统评分(APACHEⅡ)、序贯器官衰竭估计评分(SOFA)]。结果:生存组脓毒症患者占比(63.83%)高于死亡组(23.08%),而脓毒症休克患者占比(36.17%)低于死亡组(76.92%),差异有统计学意义(P<0.05)。生存组降钙素原、白细胞计数、血小板计数、中性粒细胞计数指标与死亡组比较,差异无统计学意义(P>0.05)。生存组淋巴细胞计数水平高于,差异有统计学意义(P<0.05);生存组血乳酸水平、NLR值均低于死亡组,差异有统计学意义(P<0.05)。生存组APACHEⅡ评分、SOFA评分均低于死亡组,差异有统计学意义(P<0.05)。双变量Pearson直线相关检验结果显示,NLR与APACHEⅡ、SOFA评分相关性均呈正相关(r>0,P<0.05)。结论:相较于脓毒症休克患者,脓毒症患者的生存率较高;NLR对于脓毒症患者预后具有重要的预测价值,联合血乳酸、APACHEⅡ评分及SOFA评分进行预后预测可能具有更重要的临床意义。

Objective To investigate the predictive value of neutrophil/lymphocyte ratio(NLR)in the prognosis of patients with sepsis.Methods From May 2019 to May 2021,60 patients with sepsis who were admitted to Shenzhen Bao'an District Central Hospital were selected as the research subjects.group(n=13).Retrospective analysis and comparison of the severity of illness,laboratory-related indicators(white blood cell count,platelet count,blood lactate level,NLR)and clinical-related indicators[acute physiology and chronic health status scoring system(APACHE II),sequence Organ Failure Assessment Score(SOFA)].Results The proportion of patients with sepsis in the survival group(63.83%)was higher than that in the death group(23.08%),while the proportion of patients with septic shock(36.17%)was lower than that in the death group(76.92%),with a statistically significant difference(P<0.05).There was no significant difference in procalcitonin,white blood cell count,platelet count and neutrophil count between the survival group and the death group(P>0.05).The lymphocyte count level in the survival group was higher than that in the survival group,and the difference was statistically significant(P<0.05).The APACHE II score and SOFA score of the survival group were lower than those of the death group,and the difference was statistically significant(P<0.05).The bivariate Pearson linear correlation test showed that NLR was positively correlated with APACHEII and SOFA scores(r>0,P<0.05).Conclusion Compared with patients with septic shock,the survival rate of patients with sepsis is higher;NLR has important predictive value for the prognosis of patients with sepsis,and the combination of blood lactate,APACHE II score and SOFA score may have better prognosis prediction.important clinical significance.