中性粒细胞与淋巴细胞比值、血小板计数与淋巴细胞比值及脂蛋白在急性胰腺炎患者中的检测价值

Detection value of neutrophil to lymphocyte ratio and platelet count to lymphocyte ratio and lipoprotein on patients with acute pancreatitis

目的:分析不同严重程度急性胰腺炎(AP)患者外周血中性粒细胞与淋巴细胞比值(NLR)、血小板计数与淋巴细胞比值(PLR)、载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)、脂蛋白a[Lp(a)]的水平及其在AP患者中的检测价值。方法:回顾性分析2020年1月至2023年12月郑州市第二人民医院收治的69例AP患者的临床资料,根据病情严重程度将其分为3组,比较不同病情严重程度AP患者治疗前外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平;采用Spearman相关性分析方法分析外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平与AP严重程度的相关性。根据患者是否发生器官衰竭将其分为预后良好组(n=56)和预后不良组(n=13),比较两组患者外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平,使用受试者工作特征(ROC)曲线分析外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平对AP患者预后的预测价值。结果:不同病情严重程度AP患者外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平比较存在显著性差异(P<0.05)。经Spearman相关性分析,外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平与AP严重程度均呈正相关(P<0.05)。预后不良组患者外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平均显著高于预后良好组(P<0.05)。ROC曲线中,外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平预测AP患者预后的曲线下面积(AUC)分别为0.837、0.793、0.827、0.757,敏感度分别为92.31%、92.31%、84.62%、76.92%,特异度分别为75.00%、66.07%、76.79%、71.43%。结论:外周血NLR、PLR、ApoB/ApoA1、Lp(a)水平与AP严重程度密切相关,且在预测AP患者预后中均具有较高价值。

Objective:To analyze the detection value of peripheral blood neutrophil to lymphocyte ratio(NLR),platelet count to lymphocyte ratio(PLR),apolipoprotein B/apolipoprotein A1(ApoB/ApoA1)and lipoprotein a[Lp(a)]on patients with varying degrees of acute pancreatitis(AP).Methods:Clinical data of 69 patients with AP admitted to the Second People's Hospital of Zhengzhou from January 2020 to December 2023 were retrospectively analyzed,and they were divided into three groups according to the severity of the disease.The levels of NLR,PLR,ApoB/ApoA1 and Lp(a)in peripheral blood of AP patients with different severity before treatment were compared.Spearman correlation analysis method was used to analyze the correlation between peripheral blood NLR,PLR,ApoB/ApoA1 and Lp(a)levels and AP severity.According to whether they developed organ failure or not,they were divided into good prognosis group(n=50)and poor prognosis group(n=13),and the peripheral blood NLR,PLR,ApoB/ApoA1 and Lp(a)were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of peripheral blood NLR,PLR,ApoB/ApoA1 and Lp(a)levels on predicting the prognosis of AP patients.Results:There were significant differences in the levels of NLR,PLR,ApoB/ApoA1 and Lp(a)in peripheral blood of AP patients with different disease severity(P<0.05).Spearman correlation analysis showed that the levels of NLR,PLR,ApoB/ApoA1 and Lp(a)in peripheral blood were positively correlated with the severity of AP(P<0.05).The levels of NLR,PLR,ApoB/ApoA1 and Lp(a)in peripheral blood of patients with poor prognosis were significantly higher than those of patients with good prognosis(P<0.05).In ROC curve,areas under the curves(AUCs)of peripheral blood NLR,PLR,ApoB/ApoA1 and Lp(a)levels in predicting the prognosis of AP patients were 0.837,0.793,0.827 and 0.757,respectively,and the sensitivity was 92.31%,92.31%,84.62%and 76.92%,respectively.The specificity was 75.00%,66.07%,76.79%and 71.43%,respectively.Conclusions:The levels of NLR,PLR,ApoB/ApoA1 and Lp(a)in peripheral blood are closely related to the severity of AP,and have high value in predicting the prognosis of AP patients.