NLR、PLR和DD与急性胆管炎严重程度的相关性研究

Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and D-dimer with the severity of acute cholangitis

目的探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、D-二聚体(DD)与急性胆管炎严重程度的相关性。方法回顾性分析盘锦市中心医院2019年9月至2021年3月收治的急性胆管炎患者96例的临床资料,依据严重程度分为三组:急性轻度胆管炎36例(A组),急性中度胆管炎35例(B组),急性重度胆管炎25例(C组)。比较三组患者年龄、性别、NLR、PLR、DD与急性胆管炎严重程度的相关性。结果A组与B组DD、NLR和PLR水平的受试者工作特征曲线(ROC曲线)下面积(AUC)分别为0.800、0.838、0.721,最佳截断值分别是1.985 mg/L、9.589、154.410,其中NLR的AUC最大,灵敏度最高为82.9%,诊断价值高。B组与C组DD、NLR和PLR水平的AUC分别为0.967、0.915、0.543,最佳截断值分别是6.000 mg/L、22.390、264.220,其中DD、NLR有诊断学意义(P<0.05),但PLR无诊断学意义(P>0.05),其中DD的AUC最大,诊断意义较大。当三项指标联合检测时AUC最大,诊断价值最高,A组与B组AUC为0.866,B组与C组AUC为0.977。结论急性胆管炎患者DD、NLR、PLR水平均升高,与疾病严重程度相关,DD、NLR、PRL均可作为轻、中度之间的评定指标,NLR价值较高。DD、NLR可作为中重度急性胆管炎的评定指标,DD效果优于NLR。三者联合检测可提高对急性胆管炎严重程度的诊断价值,且优于单项检测,有助于临床诊疗。

Objective To correlate neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and D-dimer(DD)with the severity of acute cholangitis.Methods The clinical data of 96 patients with acute cholangitis who received treatment in Panjin Central Hospital from September 2019 to March 2021 were retrospectively analyzed.These patients were divided into three groups according to the severity of acute cholangitis:36 patients with mild acute cholangitis(group A),35 patients with moderate acute cholangitis(group B),and 25 patients with severe acute cholangitis(group C).The correlation between age,sex,NLR,PLR,DD,and the severity of acute cholangitis was compared among the three groups.Results In groups A and B,the area under the receiver operating characteristic curve(AUC)showing the performance of DD,NLR,and PLR levels in predicting acute cholangitis was 0.800,0.838,and 0.721,respectively,with the optimal cut-off value of 1.985 mg/L,9.589,and 154.410,respectively.Among them,NLR had the largest AUC,and the highest sensitivity(82.9%),and had a high diagnostic value.In groups B and C,the AUC for DD,NLR,and PLR was 0.967,0.915,and 0.543,respectively,with the optimal cut-off value of 6.000 mg/L,22.390,and 264.220,respectively.DD and NLR had a diagnostic significance(both P<0.05),but PLR had no diagnostic significance(P>0.05).The AUC for DD was the largest,and therefore DD had a great diagnostic significance.When NLR,PLR,and DD were jointly detected,the AUC was the highest and the diagnostic value was the highest.The AUC in groups A and B was 0.866,and that in groups B and C was 0.977.Conclusion The levels of DD,NLR,and PLR increase in patients with acute cholangitis,which are related to the severity of the disease.DD,NLR,and PRL can be used as indicators to evaluate mild and moderate acute cholangitis,and NLR has the highest diagnostic value.DD and NLR can be used as indicators to evaluate moderate to severe acute cholangitis,and the effect of DD is superior to that of NLR.The combined detection of the three indicators can increase the value to evaluate the severity of acute cholangitis,and its effect is superior to that of a single detection.The combined detection of NLR,PLR,and DD is helpful for the clinical diagnosis and treatment of acute cholangitis.