中性粒细胞百分比与白蛋白比值对吉兰-巴雷综合征患者短期预后的预测价值

Short-term prognostic value of neutrophil percentage to albumin ratio in patients with Guillain-Barrésyndrome

目的探讨中性粒细胞百分比与白蛋白比值(NPAR)对吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)患者短期预后的预测价值。方法回顾性分析2018年1月至2022年12月南阳市中心医院收治的226例GBS患者的临床资料。根据患者出院时休斯功能分级量表(Hughes functional grading scale,HFGS)评分将患者分为短期预后良好组(HFGS<3分,n=119)和短期预后不良组(HFGS≥3分,n=107)。比较两组患者间性别构成、年龄、临床症状、体征、血液检查、脑脊液检查、免疫治疗等指标的差异。采用Spearman相关性分析NPAR与GBS患者短期预后的关系;采用多因素Logistic回归分析影响GBS患者短期预后的危险因素;绘制ROC曲线分析NPAR对GBS患者短期预后的预测价值。结果与短期预后良好组比较,短期预后不良组患者住院时间更长,肌张力低、腱反射减弱或消失、使用呼吸机、入住ICU、血浆置换患者比例高,白细胞计数、淋巴细胞计数、中性粒细胞百分比、脑脊液葡萄糖水平、NPAR高,白蛋白水平、预后营养指数更低(均P<0.05)。NPAR与GBS患者短期预后不良呈正相关(r=0.478,P<0.01)。多因素Logistic回归分析显示,NPAR、白蛋白、入住ICU、住院时间是影响GBS患者短期预后的独立危险因素(P<0.05)。ROC曲线结果显示,NPAR预测GBS患者短期预后的AUC为0.776(95%CI:0.716~0.836,P<0.01)。结论入院时NPAR与GBS患者短期预后不良相关,NPAR对评估GBS患者的短期预后具有较高的临床价值。

Objective To investigate the predictive value of neutrophil percentage to albumin ratio(NPAR)in short-term prognosis of patients with Guillain-Barrésyndrome(GBS).Methods The clinical data of 226 GBS patients admitted to Nanyang Central Hospital from January 2018 to December 2022 were retrospectively analyzed.According to the Hughes functional grading scale(HFGS)score at discharge,the patients were divided into good short-term prognosis group(HFGS<3 points,n=119)and poor short-term prognosis group(HFGS≥3 points,n=107).The differences of gender composition,age,clinical symptoms,signs,blood examination,cerebrospinal fluid examination and immunotherapy were compared between the two groups.Spearman correlation was used to analyze the relationship between NPAR and short-term prognosis of GBS patients.Multivariate Logistic regression was used to analyze the risk factors affecting the short-term prognosis of GBS patients.ROC curve was drawn to analyze the predictive value of NPAR in short-term prognosis of GBS patients.Results Compared with the good short-term prognosis group,patients in the poor short-term prognosis group had longer hospital stay,lower muscular tone,decreased or disappeared tendon reflexes,higher rates of ventilators,ICU admission,plasma pheresis,and higher white blood cell count,lymphocyte count,neutrophil percentage,cerebrospinal fluid glucose level,and NPAR.The levels of albumin and prognostic nutritional index were lower in the poor short-term prognosis group(all P<0.05).NPAR was positively correlated with poor short-term prognosis in GBS patients(r=0.478,P<0.01).Multivariate Logistic regression analysis showed that NPAR,albumin,ICU stay,and length of stay were independent risk factors for short-term prognosis of GBS patients(P<0.05).ROC curve results showed that the AUC of NPAR in predicting the short-term prognosis of GBS patients was 0.776(95%CI:0.716-0.836,P<0.01).Conclusions NPAR is associated with poor short-term prognosis of GBS patients upon admission,and NPAR has high clinical value in evaluating short-term prognosis of GBS patients.