急性胰腺炎患者中性粒淋巴细胞比值及其他实验室相关指标与疾病严重程度的相关性分析

Correlation between neutrophil lymphocyte ratio and other laboratory related indexes and disease severity in patients with acute pancreatitis

目的 研究急性胰腺炎(AP)患者中性粒淋巴细胞比值(NLR)及其他实验室相关指标与疾病严重程度的相关性。方法 选取2019年7月—2021年7月太和县人民医院收治的AP患者102例,设为观察组,参照2012年亚特兰大修订分类标准,所有患者可分为轻症急性胰腺炎(MAP,n=53)、重症急性胰腺炎(SAP,n=49);另外选取同期于本院体检且身体健康的51名志愿者作为研究对象,设为对照组(n=51)。记录所有研究对象的年龄、性别及观察组的病因等一般资料,分别检测并记录两组受试者及观察组中MAP与SAP患者的NLR、其他实验室相关指标[凝血原酶时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(BPC)、血清淀粉酶(AMS)],经ROC分析NLR、PT、APTT、INR、FIB、D-D、BPC、AMS预测AP的价值,最后Person系数分析NLR及其他实验室相关指标与AP严重程度的相关性。结果 观察组NLR、PT、APTT、INR、FIB、D-D、AMS均显著高于对照组,BPC显著低于对照组,差异有统计学意义(均P<0.05)。经ROC分析,NLR、PT、APTT、INR、FIB、D-D、BPC、AMS预测AP的曲线下面积分别为0.847、0.756、0.851、0.889、0.798、0.896、0.846、0.883,差异均有统计学意义(P<0.05)。SAP患者NLR、PT、APTT、INR、FIB、D-D、AMS均显著高于MAP患者,BPC显著低于MAP患者,差异有统计学意义(均P<0.05)。经相关性分析证实,NLR、PT、APTT、INR、FIB、D-D、AMS均与疾病严重程度呈正相关,差异均有统计学意义(P<0.05);BPC与疾病严重程度呈负相关,差异均有统计学意义(P<0.05)。结论 AP患者会出现凝血功能紊乱及全身炎症反应,经Person系数分析证实NLR及其他相关实验室指标均与AP疾病严重程度具备显著相关性,NLR与其他本研究探讨的实验室相关指标可作为AP发展成SAP的预测指标,对指导临床诊治具有重要价值,值得临床推广应用。

Objective To study the correlation between neutrophil lymphocyte ratio(NLR) and other laboratory related indexes and disease severity in patients with acute pancreatitis(AP).Methods 102 patients with AP(observation group)were divided into 2 groups according to the severity of illness:mild acute pancreatitis(MAP) subgroup(n=53) and severe acute pancreatitis(SAP) subgroup(n=49).51 healthy physical examinee at the same time were selected as controls.The age and gender of all subjects and the etiology of the observation group were recorded.NLR and other laboratory-related indicators [Prothrombin time(PT),Activated partial thromboplastin time(APTT),International Normalized ratio(INR),fibrinogen(FIB),D-dimer(D-D),blood platelet count(BPC),serum amylase(AMS)] of MAP and SAP patients in the two groups and the observation group were detected and recorded.,The predictive value of NLR,PT,APTT,INR,FIB,DD,BPC and AMS were analyzed by ROC.Finally,the correlation between NLR and other laboratory-related indicators and AP severity was analyzed by Person coefficient.Results The levels of NLR,PT,APTT,INR,FIB,D-D,and AMS in the observation group were all significantly higher than those in the control group,and the BPC level of the observation group was significantly lower than that in the control group(all P<0.05).By ROC analysis,he areas under the curve predicted by NLR,PT,APTT,INR,FIB,D-D,BPC,and AMS were 0.847,0.756,0.851,0.889,0.798,0.896,0.846,and0.883 respectively,the difference was statistically significant(P<0.05).The levels of NLR,PT,APTT,INR,FIB,D-D,and AMS in the SAP patients were all significantly higher than those in the MAP patients,and the blood platelet count of the SAP patients was significantly lower than those in the MAP patients(P<0.05).Correlation analysis showed that NLR,PT,APTT,INR,FIB,D-D,and AMS were positively correlated with disease severity(P<0.05),and PC was negatively correlated with disease severity(all P<0.05).Conclusion Patients with AP will have coagulation dysfunction and systemic inflammatory reaction.The person coefficient analysis shows that NLR and other relevant laboratory indicators are significantly correlated with the severity of AP disease.NLR and other laboratory related indicators discussed in this study can be used as the prediction indicators for the development of AP into SAP,which is of great value in guiding clinical diagnosis and treatment,and is worthy of clinical application.