老年脓毒症患者中性粒细胞与淋巴细胞比值的临床意义

The Clinical Value of Neutrophil-lymphocyte Ratio in Assessment of Elderly Sepsis Patients

目的 探讨中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio, NLR)与脓毒症严重程度及预后的相关性。方法 选取北京丰台医院2022年1-11月进入急诊科抢救室就诊的126例老年脓毒症患者作为病例组,选取36例健康者为对照组,比较NLR,将病例组按照确诊分为:脓毒症组(77例)与脓毒症休克组(49例),比较两组间的NLR以及血清降钙素原(PCT)、急性生理学与慢性健康状况Ⅱ评分(APACHEⅡ)、序贯器官功能衰竭评分(SOFA)的差异。随访28d,分析死亡组(95例)和存活组(31例)NLR以及PCT、APACHEⅡ评分、SOFA评分的差异。分析NLR的水平与PCT,APACHEⅡ评分、SOFA评分的相关性。结果 病例组的NLR高于健康组,差异有统计学意义(P<0.05)。脓毒症休克组的NLR以及PCT、APACHEⅡ评分、SOFA评分高于脓毒症组,差异有统计学意义(P<0.05)。老年脓毒症患者中死亡组的NLR以及PCT、APACHEⅡ评分、SOFA评分高于存活组,差异有统计学意义(P<0.05)。病例组患者中NLR与PCT,APACHEⅡ评分、SOFA评分呈正相关的关系,差异有统计学意义(P<0.05)。结论 NLR对老年脓毒症患者病情严重程度及预后具有判断价值。

Objective To study the relationship of between neutrophil-lymphocyte ratio(NLR)and the illness in elderly sepsis patients,The correlation between NLR and procalcitonin、APACHEⅡ、sequential organ failure assessment(SOFA),were analyzed in elderly sepsis patients.Methods 126 elderly patients with sepsis(case group)admitted to emergency room of Fengtai hospital from January 2022 to November were divided into two groups:sepsis(77 cases),and sepsis shock(49 cases).Volunteers from the health examination center at the same time were included as the control group.The indexes of NLR were compared between the case group and the control group.The indexes of NLR and PCT、APACHEⅡ、the scores of SOFA were compared between two groups.After 28 days’following up,the above clinical data were compared between death group(31 cases)and survival group(95 cases).The indexes of NLR and PCT、APACHEⅡ、the scores of SOFA were compared among between two groups.Results The value of NLR in case group were higher than those in the control group,and the difference was statistically significant(P<0.05).The value of NLR and PCT、APACHEⅡ、the scores of SOFA in sepsis shock were higher than those in sepsis,and the difference was statistically significant(P<0.05).The value of NLR and PCT、APACHEⅡ、the scores of SOFA in death group among the sepsis patients were higher than those in survival group,and the difference was statistically significant(P<0.05).In case group,The NLR and PCT,APACHEⅡ、the scores of SOFA were determined with positive linear correlation respectively,and the difference was statistically significant.Conclusion Neutrophil-lymphocyte ratio are the valuable factor on the severity and prognosis in elderly sepsis patients.