外周血WBC和NLR对肥胖症合并胃食管反流病的临床诊断价值

Clinical diagnostic value of peripheral white blood cell count and neutrophil-to-lymphocyte ratio in obesity with gastroesophageal reflux disease

目的探讨外周血白细胞计数(WBC)和中性粒细胞与淋巴细胞比值(NLR)对肥胖症合并胃食管反流病(GERD)的临床诊断价值。方法回顾性分析2020年1月-2022年1月新疆维吾尔自治区人民医院收治的118例肥胖症患者的临床资料。根据病史及检查结果分为肥胖症合并GERD组(n=57)与未合并GERD组(n=61)。采用单因素和多因素logistic回归分析肥胖症合并GERD的危险因素。采用受试者工作特征(ROC)曲线评估外周血WBC和NLR单独与联合检测对肥胖症合并GERD的临床诊断价值。结果合并GERD组吸烟史(31.6%vs.14.8%,P=0.030)、GERD家族史(43.9%vs.24.6%,P=0.027)占比,外周血WBC[(10.25±1.81)×10^(9)/Lvs.(8.72±2.11)×10^(9)/L,P<0.001]、NLR(3.55±0.71vs.3.00±0.64,P<0.001),以及空腹血糖[(6.39±2.21)mmol/L vs.(5.76±0.85)mmol/L,P=0.041]均高于未合并GERD组。多因素logistic回归分析结果显示,外周血WBC和NLR是肥胖症合并GERD的独立危险因素(P<0.05)。ROC曲线分析显示,外周血WBC(AUC=0.707)和NLR(AUC=0.722)对肥胖症合并GERD具有较高的临床诊断价值(P<0.001),且两者联合能够提高诊断效能(AUC=0.786)。结论外周血WBC和NLR是肥胖症合并GERD的独立危险因素,对肥胖症合并GERD具有较高的诊断价值,两者联合能够提高诊断效能,具有一定的临床应用价值。

Objective To investigate the clinical diagnostic value of peripheral white blood cell count(WBC)and neutrophil-to-lymphocyte ratio(NLR)in obesity with gastroesophageal reflux disease(GERD).Methods The clinical data of 118 patients of obesity admitted to People's Hospital of Xinjiang Uygur Autonomous Region from January 2020 to January 2022 were retrospectively analyzed.Based on the medical history and examination results,the patients were divided into obesity with GERD group(n=57)and obesity without GERD group(n=61).Univariate and multivariate logistic regression were used to analyze the risk factors of obesity combined with GERD.Receiver operating characteristic(ROC)curve was used to evaluate the clinical diagnostic value of peripheral WBC and NLR testing alone vs.combined testing for obesity combined with GERD.Results The obesity with GERD group had a higher proportion of smoking history(31.6%vs.14.8%,P=0.030),family history of GERD(43.9%vs.24.6%,P=0.027),and WBC of peripheral blood[(10.25±1.81)×10^(9)/L vs.(8.72±2.11)×10^(9)/L,P<0.001],NLR(3.55±0.71 vs.3.00±0.64,P<0.001),and fasting plasma glucose[(6.39±2.21)mmol/L vs.(5.76±0.85)mmol/L,P=0.041]were higher in obesity without GERD group.The results of multivariate logistic regression analysis showed that peripheral WBC and NLR were independent risk factors for the obesity combined with GERD(P<0.05).ROC curve analysis showed that peripheral WBC(AUC=0.707)and NLR(AUC=0.722)had high clinical diagnostic values for obesity combined with GERD(P<0.001),and the combination of them improved the diagnostic efficacy(AUC=0.786).Conclusion Peripheral WBC and NLR are independent risk factors for the obesity combined with GERD,and are of great diagnostic value for obesity combined with GERD,and the combination of the two can improve the diagnostic efficacy and have a certain clinical value.