Predictive Value of the Neutrophil to Lymphocyte Ratio (NLR) to Predict the Development of Preeclampsia and Pregnancy Induced Hypertension at 1st Trimester

Introduction: Hypertensive disorder in pregnancy affects 4 to 6 percent of all pregnancies and carries risks for the both baby and the mother. Only a few groups of women who are at high-risk pregnancies are received prophylaxis Aspirin, more than 15 percent of women develop pre-eclampsia with a single minor risk factor. Methods: This descriptive cross-sectional study was conducted to compare the 1st trimester NLR value of normotensive, pregnancy induced hypertensive and pre-eclamptic pregnant women. The study was conducted with a sample of 416, antenatal patients who were admitted to ward 25, at Colombo North Teaching Hospital Ragama. Data was collected as separated three groups. NLR value was calculated separately and ANOVA test was used to analyze the 3 categorical data. Post HOC test was done to assess the multiple comparison. Results: The prevalence rates of pregnancy induced hypertension and pre-eclampsia among the pregnant women were 8.6% and 5.7%. The mean NLR values of normotensive group was 2.708, pregnancy induced hypertensive group was 2.650 and pre eclamptic group was 3.789. There was a significant difference in NLR value between pre eclamptic group and other two groups with P value of Conclusion: The 1st trimester NLR value of pre eclamptic patients significantly increased compared to normotensive women.

Prognostic Value of Neutrophil to Lymphocyte Ratio in Acute Myeloid Leukemia

Objective: Acute myeloid leukemia (AML) is a heterogeneous, hematologic malignancy at which short survival may be seen. Our study aims to evaluate the effect of the neutrophil-to-lymphocyte ratio (NLR) on the course of the disease, response to therapy, and overall survival (OS). Materials and Methods: A total of 124 patients followed-up with the diagnosis of AML from 2016 to 2019 were retrospectively examined. Results: 69 of the cases (55.6%) were men and 55 (44.3%) were women. The average age at the time of diagnosis was 53.44 ± 30.3 years old. We determined the NLR as median 0.46 (0.16 - 1.1). In AML, 69 patients were responsive to the induction regimen (57.9%) while 46 patients were unresponsive (37.8%). 5 patients died before completing the regimen. D-dimer was found to be higher and fibrinogen was found to be lower in the responsive group. Lower OS was observed in cases of >60 years of age, male gender, non-APL AML, high NLR, and recurrence at diagnosis. Recurrences were detected in 23 patients (18.5%) and the median time to the recurrence was 416 (236 - 639) days. Fibrinogen level and the bone marrow blast ratio at the time of application were determined to be associated with recurrence. The median follow-up time was 856 (143 - 1276) days. Final condition analysis reveals that 74 patients (59.6%) are alive. Conclusion: We determined in our study that the NLR is effective on survival. Medical literature on this subject is scanty and prospective studies with large patient groups are needed.

Prognostic Value of Neutrophil to Lymphocyte Ratio for In-hospital Mortality in Elderly Patients with Acute Myocardial Infarction

Coronary artery disease （CAD） is a multifactorial disease in which inflammation plays a central role. This study aimed to investigate the association of inflammatory markers such as the neutrophil to lymphocyte ratio （NLR）, the Global Registry of Acute Coronary Events （GRACE） score with in-hospital mortality of elderly patients with acute myocardial infarction （AMI） in an attempt to explore the prognostic value of these indices for elderly AMI patients. One thousand consecutive CAD patients were divided into two groups based on age 60. The laboratory and clinical characteristics were assessed retrospectively by reviewing the medical records. The NLR and GRACE score were calculated. In the elderly （〉60 years）, patients with non-ST-elevation myocardial infarction （NSTEMI） and ST-elevation myocardial infarction （STEMI） had significantly higher NLR than did those with unstable angina （UA） and stable angina pectoris （SAP） （P〈0.01）. The NLR was considerably elevated in older AMI patients compared with their younger counterparts （〈60 years） （P〈0.05）. In elderly AMI patients, the NLR was considerably higher in the high-risk group than in both the low-risk and mediumrisk groups based on the GRACE score （P〈0.05 and P〈0.01, respectively）, and the NLR was positively correlated with the GRACE score （r=0.322, P〈0.001）. Either the NLR level or the GRACE score was significantly higher in the death group than in the surviving group （P〈0.05）. By curve receiver operator characteristic curve （ROC） analysis, the optimal cut-off levels of 9.41 for NLR and 174 for GRACE score predicted in-hospital death [ROC area under the curve （AUC） 0.771 and 0.787, respectively, P〈0.001]. It was concluded that an elevated NLR is a potential predictor of in-hospital mortality in elderly patients with AMI.

Neutrophil to lymphocyte ratio and albumin bilirubin grade in hepatocellular carcinoma: A systematic review

BACKGROUND Hepatocellular carcinoma(HCC)is a frequent cause of cancer related death globally.Neutrophil to lymphocyte ratio(NLR)and albumin bilirubin(ALBI)grade are emerging prognostic indicators in HCC.AIM To study published literature of NLR and ALBI over the last five years,and to validate NLR and ALBI locally in our centre as indicators of HCC survival.METHODS A systematic review of the published literature on PubMed of NLR and ALBI in HCC over the last five years.The search followed the guidelines of the preferred reporting items for systematic reviews and meta-analyses.Additionally,we also investigated HCC cases between December 2013 and December 2018 in our centre.RESULTS There were 54 studies describing the relation between HCC and NLR and 95 studies describing the relation between HCC and ALBI grade over the last five years.Our local cohort of patients showed NLR to have a significant negative relationship to survival(P=0.011).There was also significant inverse relationship between the size of the largest HCC nodule and survival(P=0.009).Median survival with alpha fetoprotein(AFP)<10 KU/L was 20 mo and with AFP>10 KU/L was 5 mo.We found that AFP was inversely related to survival,this relationship was not statically significant(P=0.132).Mean survival for ALBI grade 1 was 37.7 mo,ALBI grade 2 was 13.4 months and ALBI grade 3 was 4.5mo.ALBI grades performed better than Child Turcotte Pugh score in detecting death from HCC.CONCLUSION NLR and ALBI grade in HCC predict survival better than the conventional alpha fetoprotein.ALBI grade performs better than Child Turcotte Pugh score.These markers are done as part of routine clinical care and in cases of normal alpha fetoprotein,these markers could give a better understanding of the patient disease progression.NLR and ALBI grade could have a role in modified easier to learn staging and prognostic systems for HCC.

Usefulness of the Pediatric Appendicitis Score and Neutrophil to Lymphocyte Ratio for Assessing the Complicated Appendicitis in Children

Introduction: Acute appendicitis (AA) is a common surgical disease which occurs in almost all age groups, and especially in childhood. Acute appendicitis is one of the most common causes of acute abdomen. The lifetime occurrence of this disease is approximately 7%, with perforation rate of up to 20%. In spite of the well-known classical symptoms and clinical findings of acute appendicitis, early diagnosis can be sometimes challenging. For the treatment of simple appendicitis (SA) in children, the effectiveness of antibiotic treatment has been reported. We aimed to determine predictive value of combination NLR and PAS in pediatric patients with clinical suspicion of acute appendicitis and complicated appendicitis Methods: Our study was performed on 480 children admitted for suspected acute appendicitis and underwent appendectomy at the MNCMCH, Ulaanbaatar Mongolia, between May 2019 and December 2019. White blood count (WBC), Neutrophil, NLR and PAS were compared between groups. Results: The sensitivity, specificity, PPV, NPV of PAS + NLR for differentiating complicated and noncomplicated appendicitis were 86.8%, 89.4%, 92.1% and 76% respectively. The sensitivity, specificity, PPV, NPV of PAS + NLR for diagnosis of acute appendicitis were 90.5%, 68.1%, 97.68% and 32.6% respectively. Conclusion: In the era of conservative antibiotic-based management of uncomplicated acute appendicitis, we advocate that combination of NLR and PAS is a useful aid in predicting complicated appendicitis.

Neutrophil to Lymphocyte Ratio in Acute Ischemic Stroke

Introduction: The neutrophil to lymphocyte ratio (NLR) can be used as a marker of subclinical inflammation, and may have a predictive power in prognosis and severity of atherosclerosis-related diseases. This study aimed to assess an association between the NLR, and clinical characteristics and one-month outcome in acute ischemic stroke (AIS). Subjects and Methods: This case-control observational prospective study included 75 patients admitted to stroke unit of Ain Shams University hospitals with AIS, sub grouped into 3 equal groups according to subtype of AIS, in addition to 25 healthy individuals. The demographic characteristics of the patients, complete blood picture test results at presentation, National Institutes of Health Stroke Scale (NIHSS) scores and modified Rankin Scale (mRS) scores were recorded. The clinical outcome was assessed by the NIHSS and mRS scores after one month. Results: The total leucocyte count was significantly higher in large artery atherosclerosis (P = 0.004) and cardioembolic (P = 0.020) stroke groups, unlike lacunar stroke group (P = 0.082), when compared to controls. The neutrophils count was higher (P < 0.001) and the lymphocyte count was lower (P < 0.001) among all the stroke groups compared to the control group. The NLR was higher among all the stroke groups compared to the control group (P < 0.001). The NLR at cutoff value more than 1.34 had predicted stroke with a sensitivity of 89.33% and specificity of 72% and accuracy reached 88.6%. There was non-significant association between NLR and each of NIHSS and mRS after one month from onset of AIS. Conclusion: NLR was significantly higher among AIS subtypes compared to controls, but not a good predictor for one month outcome.

Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: A meta-analysis

AIM:To conduct a meta-analysis evaluating theassociation between the peripheral blood neutrophil to lymphocyte ratio(NLR) and the outcome of patients with pancreatic cancer.METHODS:Studies evaluating the relationship between the peripheral blood NLR and outcome of patients with pancreatic cancer published up to May 2014 were searched using electronic databases, including Pub Med, Web of Science, Embase and Ovid.A meta-analysis was performed to pool the hazard ratios(HRs) or odds ratios(ORs) and their 95% confidence intervals(CIs) using either a fixed-effects model or a random-effects model to quantitatively assess the prognostic value of NLR and its association with clinicopathological parameters.RESULTS:Eleven studies containing a total of 1804 patients were eligible according to our selection criteria, and combined hazard ratios indicated that high NLR was a poor prognostic marker for pancreatic cancer patients because it had an unfavorable impact on the overall survival(OS)(HR =2.61, 95%CI:1.68-4.06, P =0.000) and cancer specific survival(HR =1.66, 95%CI:1.08-2.57, P =0.021).Subgroup analysis revealed that high NLR was associated with poor OS in patients with mixed treatment(HR =4.36, 95%CI:2.50-7.61, P =0.000), chemotherapy(HR =2.08, 95%CI:1.49-2.9, P =0.000), or surgical resection(HR =1.2, 95%CI:1.00-1.44, P =0.048).Additionally, high NLR was significantly correlated with tumor metastasis(OR =1.69, 95%CI:1.10-2.59, P =0.016), poor tumor differentiation(OR =2.75, 95%CI:1.19-6.36, P =0.016), poor performance status(OR =2.56, 95%CI:1.63-4.03, P =0.000), high cancer antigen 199(OR =2.62, 95%CI:1.49-4.60, P =0.000), high C-reactive protein(OR =4.32, 95%CI:2.71-6.87, P =0.000), and low albumin(OR =3.56, 95%CI:1.37-9.27, P =0.009).CONCLUSION:High peripheral blood NLR suggested a poor prognosis for patients with pancreatic cancer,and it could be a novel marker of survival evaluation and could help clinicians develop therapeutic strategies for pancreatic cancer patients.

Is the neutrophil to lymphocyte ratio associated with liver fibrosis in patients with chronic hepatitis B?

AIM: To determine the association between the neutrophil to lymphocyte(N/L) ratio and the degree of liver fibrosis in patients with chronic hepatitis B(CHB) infection. METHODS: Between December 2011 and February 2013, 129 consecutive CHB patients who were admitted to the study hospitals for histological evaluation of chronic hepatitis B-related liver fibrosis were included in this retrospective study. The patients were divided into two groups based on the fibrosis score: individuals with a fibrosis score of F0 or F1 were included in the "no/minimal liver fibrosis" group, whereas patients with a fibrosis score of F2, F3, or F4 were included in the "advanced liver fibrosis" group. The Statistical Package for Social Sciences 18.0 for Windows was used to analyze the data. A P value of < 0.05 was accepted as statistically significant.RESULTS: Three experienced and blinded pathologists evaluated the fibrotic status and inflammatory activity of 129 liver biopsy samples from the CHB patients. Following histopathological examination, the "no/minimal fibrosis" group included 79 individuals, while the "advanced fibrosis" group included 50 individuals. Mean(N/L) ratio levels were notably lower in patients with advanced fibrosis when compared with patients with no/minimal fibrosis. The mean value of the aspartate aminotransferase-platelet ratio index was markedly higher in cases with advanced fibrosis compared to those with no/minimal fibrosis.CONCLUSION: Reduced levels of the peripheral blood N/L ratio were found to give high sensitivity, specificity and predictive values in CHB patients with significant fibrosis. The prominent finding of our research suggests that the N/L ratio can be used as a novel noninvasive marker of fibrosis in patients with CHB.

The Impact of Neutrophil to Lymphocytic Ratio (NLR) as a Predictor of Treatment Outcomes in Rectal Carcinomas: A Retrospective Cohort Study

Background and aim: The prognostic role of neutrophil to lymphocyte ratio (NLR) has been shown in many solid tumors included in a recent meta-analysis of one hundred studies. We aimed to evaluate the prognostic value of neutrophil to lymphocyte ratio in treatment outcomes;response and survival of patients with different stages of rectal cancers. Patients and methods: All patients with pathologically confirmed cancer rectum presented to our department during the period from January 2012 to the end of 2014 were included in this retrospective study, these recruited patients were evaluated through their files to determine different objectives of our study. Results: The median overall survival was 31 ± 4.676 months while disease free survival was 40 ± 2.346 for the whole study group;neutrophil to lymphocyte ratio was negatively correlated with overall survival with r = –0.743, P disease free survival with r = –0.717, P total number of lymph nodes dissected ratio with r = +0.254, P = 0.028. Roc curve was used to find the accurate cut point of NLR for these patients and was found to be of 4.5. Conclusion: Elevated pre-treatment NLR is an independent predictor of shorter survival in patients with rectal cancer. This parameter is a simple, easily accessible laboratory test for identifying patients with poorer prognosis.

The relation between differential leukocyte count, neutrophil to lymphocyte ratio and the presence and severity of coronary artery disease

Objectives: Total leukocyte count, a marker of inflammation has long been reported to be related with coronary artery disease (CAD). Recently, differenttial leukocyte count and elevated neutrophil to lymphocyte ratio (N/L) has been shown to indicate an increased long-term risk of mortality in patients with stable CAD, myocardial infarction and undergoing cardiovascular surgery. Thses studies offer incremental prognostic value to total leukocyte count. We sought to determine the relationship between the leukocyte subtypes and N/L ratio and the presence and extent of CAD. Study design: The study consisted of 107 patients [70 (65.4%) men, 37 (34.6%) women, mean age 59.5 ± 10.6 years] referred to coronary angiography with suspected CAD. The subjects were classified into two groups according to the presence of significant CAD and the extent of CAD was determined by the Gensini method. Results: The lymphocyte count was found to be lower (2031 ± 741 cells/μL vs 2392 ± 611 cells/μL, p: 0.010) and the N/L ratio was found to be higher in patients with CAD (2.86 ± 1.57 vs 2.04 ± 1.01, p p: 0.005]. Conclusion: Our findings reveal that N/L ratio, a simple marker which can be derived from a routine complete blood count test was significantly and independently related to presence and severity of coronary atherosclerosis.

The Importance of Neutrophil to Lymphocyte Ratio and Peripheral Blood Eosinophilia in Chronic Obstructive Pulmonary Disease Patients with Acute Exacerbation: Recent Studies

Chronic obstructive pulmonary disease (COPD) is a chronic, progressive respiratory disease and the third leading cause of respiratory disease mortality. The diagnosis of COPD is changed to acute exacerbation of COPD (AECOPD) when respiratory symptoms become worse, beyond normal day-to-day variations and severely enough that changes in medication are required. Both neutrophils to lymphocyte ratio (NLR) and peripheral blood eosinophilia (PBE) are rapid and relatively inexpensive tests that can be easily applied in the clinical practice for the diagnosis and treatment of AECOPD patients. Furthermore, current studies found that NLR and PBE had a higher accuracy rate than other traditional markers (Leukocyte count and C-reactive protein) for the diagnosis and management of AECOPD. Besides, recent studies determined that NLR and PBE can be used for prediction of future exacerbations in COPD patients. This review aims to explore the current knowledge about the significance of NLR and PBE in AECOPD patients.

乳腺癌患者血清NLR、CA199水平与诺丁汉预后指数的关系研究

目的探讨乳腺癌患者血清中性粒细胞/淋巴细胞比值(NLR)、糖类抗原(CA199)水平、诺丁汉预后指数(NPI)之间的关系,以及在乳腺癌预后评估中的应用价值。方法回顾性分析2017年6月—2021年6月在淮安市中医院确诊的72例乳腺癌患者的临床资料,根据NPI将患者分为低风险组(16例)、中风险组(34例)及高风险组(22例),比较3组患者血清NLR、CA199水平及NPI的差异。对患者进行24个月的随访。采用多因素一般Logistic回归模型分析导致预后不良的影响因素。绘制受试者工作特征曲线分析血清NLR、CA199水平及NPI对乳腺癌预后不良的预测价值。结果3组血清NLR、CA199水平比较,差异均有统计学意义(P<0.05),高风险组血清NLR、CA199水平均高于低风险组和中风险组(P<0.05)。预后不良组的TNM分期、淋巴结转移、NPI、NLR及CA199水平与预后良好组比较,差异均有统计学意义(P<0.05)。多因素一般Logistic回归分析结果显示,TNM分期晚期、淋巴结发生转移、高NPI、高NLR和高CA199水平是乳腺癌患者预后不良的独立危险因素(P<0.05)。血清NLR、CA199、NPI三者联合预测乳腺癌患者预后不良的曲线下面积为0.922(95%CI:0.812,0.999),敏感性为86.7%(95%CI:0.695,1.000),特异性为98.2%(95%CI:0.948,1.000)。结论乳腺癌患者的血清NLR、CA199、NPI之间存在关系,可作为评估乳腺癌预后的有用工具。

外周血NLR、NMR、LMR表达与帕金森病的相关性研究

目的探讨外周血中性粒细胞与淋巴细胞之比(NLR)、中性粒细胞与单核细胞之比(NMR)、淋巴细胞与单核细胞之比(LMR)表达水平与帕金森病(PD)的相关性。方法选取224例原发性PD患者为病历组,230例健康人为对照组,检测其外周血中NLR、NMR、LMR水平。①比较PD组和对照组间的NLR、NMR、LMR水平是否存在差异;②比较PD组按照不同因素分层后NLR、NMR、LMR水平是否存在差异;③分析PD组NLR、NMR、LMR的水平是否与临床特征之间存在相关性。结果①在总体样本中,PD组和对照组间NLR、NMR、LMR水平的比较差异均无统计学意义(均P>0.05)。按照性别、年龄分层,各亚组PD患者与其相对应正常对照组间NLR、NMR、LMR水平差异均无统计学意义(均P>0.05);②PD组按不同因素分层后:A.发病年龄>65岁PD组NLR水平(2.84±1.22)高于发病年龄≤65岁PD组(2.46±1.16),差异有统计学意义(P=0.018);B.女性PD组NMR水平(12.08±3.71)高于男性PD组(10.91±3.27),差异有统计学意义(P=0.013)女性PD组LMR水平(5.12±1.72)高于男性PD组(4.43±1.62),差异有统计学意义(P=0.002);C.病程>4年PD组和病程≤4年PD组间、早中晚三期PD组间、三种运动亚型(震颤为主型、姿势不稳/步态障碍型、混合型)PD组间、合并痴呆PD组和未合并痴呆PD组间的NLR、NMR、LMR水平比较差异均无统计学意义(均P>0.05);(3)PD组NLR水平与发病年龄存在正相关(r=0.223,P=0.001),LMR水平与发病年龄存在负相关(r=-0.202,P=0.002);PD组NLR、NMR、LMR水平与病程、H-Y分级、UPDRS-Ⅲ评分、NPI评分不存在相关性(均P>0.05)。结论外周血NLR、NMR、LMR水平在PD患者和正常健康人群间无差异,此三项指标均非导致PD患病的危险因素。NLR在发病年龄>65岁PD患者中的表达水平较发病年龄≤65岁PD患者高;NMR、LMR在女性PD患者中的表达水平较男性PD患者高。PD患者NLR表达水平与发病年龄呈正相关,而LMR表达水平与发病年龄呈负相关。

血清Hb、NLR、SUA/CR与糖尿病骨质疏松患者临床风险因素及利拉鲁肽治疗效果的相关性

目的分析血清血红蛋白(Hb)、中性粒细胞与淋巴细胞比值(NLR)、血尿酸/肌酐比值(SUA/CR)与糖尿病骨质疏松(DOP)患者临床风险因素的关系,并探讨三者与利拉鲁肽治疗后骨密度的相关性。方法回顾性分析2020年1月至2023年1月平顶山市第一人民医院内分泌科收治的185例糖尿病患者的临床资料,根据是否合并骨质疏松将其分为骨质疏松组58例和无骨质疏松组127例。比较两组患者的血清Hb、NLR、SUA/CR水平;经二元Logistic回归模型分析DOP的临床风险因素;采用Pearson相关性分析法分析骨质疏松患者血清Hb、NLR、SUA/CR与临床风险因素的相关性;骨质疏松组患者均采用利拉鲁肽治疗,比较其治疗前后的骨密度;采用Pearson相关性分析法分析血清Hb、NLR、SUA/CR与治疗后骨密度的相关性。结果与无骨质疏松组比较,骨质疏松组患者的年龄更大,体质量指数(BMI)、握力降低,糖尿病病程延长,差异均有统计学意义(P<0.05)。骨质疏松组患者的血清Hb水平为(112.67±15.33)g/dL,明显低于无骨质疏松组的(129.78±19.27)g/dL,而NLR、SUA/CR分别为2.68±0.57、(84.53±9.71)mg/g,明显高于无骨质疏松组的2.17±0.48、(57.63±7.17)mg/g,差异均有统计学意义(P<0.05)。二元Logistic回归模型分析结果显示,年龄(OR=8.919,95%CI:1.904~41.788)、糖尿病病程(OR=6.830,95%CI:1.147~40.689)是DOP的危险性因素,而BMI(OR=0.331,95%CI:0.148~0.738)、握力(OR=0.292,95%CI:0.121~0.705)是其保护性因素(P<0.05)。Pearson相关性分析结果显示,年龄、糖尿病病程与血清Hb呈负相关(P<0.05),BMI、握力与血清NLR、SUA/CR呈负相关(P<0.05);年龄、糖尿病病程与血清NLR、SUA/CR呈正相关(P<0.05);BMI、握力与血清Hb呈正相关(P<0.05)。骨质疏松患者经利拉鲁肽治疗后的骨密度为(0.79±0.16)g/cm^(2),明显高于治疗前的(0.65±0.12)g/cm^(2),差异有统计学意义(t=9.521,P<0.05)。Pearson相关性分析结果显示,血清Hb与治疗后骨密度呈正相关(P<0.05),血清NLR、SUA/CR与治疗后骨密度呈负相关(P<0.05)。结论血清Hb、NLR、SUA/CR与DOP的临床风险因素及利拉鲁肽治疗后骨密度密切相关,可为临床DOP风险及治疗效果评估提供参考。

蛛网膜下腔出血患者外周血NLR、LMR、PLR和SII值变化的临床意义

目的 分析动脉瘤性蛛网膜下腔出血(aSAH)对血液学参数的影响及其与患者临床状态和短期预后的关系。方法 分析2019年3月至2022年5月于四川省科学城医院神经外科治疗的62例颅内动脉瘤(IA)破裂急性期患者和55例正常对照组。采用流式细胞术分析两组患者外周血中白细胞(WBC)与淋巴细胞(LC)计数的变化,计算中性粒细胞/淋巴细胞比(NLR)、淋巴细胞/单核细胞比(LMR)、血小板/淋巴细胞比(PLR)和全身免疫-炎症指数(SII),并分析血液学参数与患者临床状况和短期预后的关系。结果 与正常对照组相比,IA破裂组WBC、中性粒细胞(Ns)计数、NLR以及SII均明显升高,而LC计数和LMR降低。此外相比于临床状态恢复良好的患者,临床状态较差的患者LC计数明显降低,而NLR、PLR和SII值明显升高。格拉斯哥昏迷评分法(GCS)评分较低的患者CD3+、CD4-、CD8-细胞比例减少。此外,LC计数降低和PLR升高与较差的短期预后相关。结论 IA破裂后会导致全身免疫和炎症反应,LC计数、NLR、PLR和SII值可以作为临床状态及预后的标志物。

NLR与MSI对急性NSTEMI短期预后判断价值

目的本研究旨在探讨校正休克指数(MSI)和中性粒细胞/淋巴细胞比值(NLR)在判断急性非ST段抬高型心肌梗死(NSTEMI)患者短期内可能出现不良预后的预测能力。方法研究组选择2020年3月到2021年9月期间,首次就诊急诊科明确诊断为急性非ST段抬高型心肌梗死的276例患者。通过快速急诊绿道监测血压与心率,并于急诊科10 min内抽取血常规、床旁心脏彩超等相关化验检查,依据监测及化验结果,研究小组计算了校正休克指数(MSI)和中性粒细胞/淋巴细胞比值(NLR),然后根据统计结果将患者分为2组:NLR≥5.0组(n=75)与NLR﹤5.0组(n=201);(2)MSI≥1.2组(n=57)与MSI<1.2组(n=219)。比较2组一般资料情况,发生不良心血管事件的比例,采用受试者ROC曲线下面积来评估NLR值和MSI值对NSTEMI院内不良心血管事件的预测能力。结果连续入选的276例NSTEMI患者中,发生不良心血管事件52例,占18.8%,心源性休克患者15例,占5.4%,恶性心律失常患者24例,占8.7%,死亡13例,占4.7%。NLR≥5.0与MSI≥1.2值组的心功能、收缩压(SBP)、舒张压(DBP)及心率(HR)分别与NLR<5.0与MSI<1.2组比较,差异有统计学意义(P<0.05);NLR≥5.0与MSI≥1.2组MACE发生率分别高于NLR<5.0组与MSI<1.2组(P<0.05)。此外,NLR和MSI的ROC曲线下面积分别为0.734和0.703,提示NLR和MSI均具有评价急性非ST段抬高型心肌梗死患者短期不良心血管事件发生能力。结论MSI与NLR是评估NSTEMI短期不良预后的两个简单的重要的易获得指标。

NLR、LMR、PLR在自身免疫性肝炎患者中的表达及意义

目的探讨自身免疫性肝炎(AIH)患者中炎性指标表达及意义。方法选取2019年1月—2022年1月龙岩市第二医院收治的91例AIH患者作为本次研究对象,作为AIH组,另外选取同期健康体检患者90例为对照组,比较两组患者肝脏生化和免疫指标及中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)、淋巴细胞-单核细胞比值(LMR)三项血细胞指标。结果AIH组患者的谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、免疫球蛋白G(IgG)等肝脏生化指标均高于对照组(均P<0.05);AIH组NLR、PLR指标水平均高于对照组,LMR水平低于对照组(均P<0.05);经过二元logistic回归分析,NLR、PLR、LMR均是AIH的独立危险因素(均P<0.05)。根据绘制ROC曲线显示,NLR、PLR、LMR的AUC值分别为0.941、0.996、0.863,PLR诊断的价值高于NLR和LMR(P<0.05)。结论肝脏生化和免疫指标与AIH发生有影响,NLR、LMR、PLR是AIH的独立危险因素,在诊断AIH具有应用价值。

宫颈癌患者血清SCC-Ag、NLR水平与临床病理特征及预后关系

目的:探讨宫颈癌患者血清鳞状细胞癌抗原(SCC-Ag)、中性粒细胞与淋巴细胞比值(NLR)与临床病理特征及预后关系。方法:纳入2018年1月-2023年1月本院收治的108例宫颈癌患者为宫颈癌组,宫颈上皮内瘤病变(CIN)患者108例为CIN组,健康体检健康女性108例为对照组。比较3组血清SCC-Ag、NLR水平,分析宫颈癌组血清SCC-Ag、NLR水平与临床病理特征及与预后关系。结果:血清SCC-Ag、NLR水平,宫颈癌组(7.35±1.76、4.65±1.06)、CIN组(2.06±0.53、3.41±0.89)、对照组(0.54±0.12、1.53±0.34)依次降低(P<0.05)。宫颈癌患者血清SCC-Ag、NLR水平与病理类型、FIGO分期、病理分级、肌层浸润深度和盆腔淋巴结转移有关(P<0.05)。Kaplan-Meier显示,SCC-Ag、NLR高表达组总生存率、无病生存率均低于SCC-Ag、NLR低表达组,SCC-Ag高表达+NLR高表达组总生存率、无病生存率最低(均P<0.05)。结论:宫颈癌患者血清SCC-Ag、NLR水平与病理类型、FIGO分期、病理分级和肌层浸润深度等有关,且SCC-Ag、NLR水平越高患者预后越差。

超声血流参数联合NLR、CA125、PLR对子宫内膜癌鉴别诊断价值

目的:探讨超声联合中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)NLR、糖类抗原125(CA125)对子宫内膜癌鉴别诊断价值。方法:收集2020年1月-2022年10月本院收治的子宫内膜癌患者92例为内膜癌组,子宫内膜良性病变患者82例为良性病变组,超声检测两组患者血流搏动指数(PI)、阻力指数(RI)、收缩期峰值流速(PSV),检测患者血清NLR、PLR、CA125水平,采用受试者工作特征(AUC)曲线分析各指标对子宫内膜癌鉴别诊断价值。结果:内膜癌组超声血流参数PSV高于对照组,PI、RI低于良性病变组,且内膜癌组Ⅲ-Ⅳ期患者PSV高于Ⅰ-Ⅱ期患者,PI、RI低于Ⅰ-Ⅱ期患者;血清CA125、NLR、PLR水平,内膜癌组均高于良性病变组,且内膜癌组Ⅲ-Ⅳ期患者高于Ⅰ-Ⅱ期患者(均P<0.05);ROC曲线分析显示,超声血流参数、CA125、NLR、PLR及联合应用鉴别诊断子宫内膜癌的曲线下面积分别为0.813、0.892,0.717、0.632、0.952,联合诊断效能最佳,敏感度98.2%。结论:超声血流参数,血清CA125、NLR、PLR在子宫内膜癌患者中发生异常,各指标联合应用对子宫内膜癌的鉴别诊断效力较高,有较好的临床指导价值。

NLR、LDH、IL-6在肺炎支原体肺炎患儿病情及预后评估中的价值

目的探讨肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)患儿中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、乳酸脱氢酶(lactate dehydrogenase,LDH)、白细胞介素-6(lnterleukin-6,IL-6)水平在预后评估中的价值。方法采用前瞻性研究方法,选取2020年9月至2021年2月昆明市儿童医院收治的180例MPP患儿作为观察组,其中普通患儿104例,重症患儿76例;另选取同期健康体检儿童60例作为对照组。比较观察组和对照组NLR、LDH、IL-6水平,评价NLR、LDH、IL-6对MPP患儿病情严重程度的评估价值。根据MPP预后情况,将患儿分为预后不良组(n=35)和预后良好组(n=145)。比较不同预后MMP患儿的临床资料、NLR、LDH、IL-6水平,分析MPP患儿预后影响因素及NLR、LDH、IL-6与临床肺部感染评分(Clinical Pulmonary Infection Score,CPIS)、白细胞计数(white blood cell count,WBC)、降钙素原(procalcitonim,PCT)及C反应蛋白(C-reactive protein,CRP)的相关性。统计学方法采用t检验、χ^(2)检验、Logistic回归分析、受试者操作特征(receiver operating characteristic,ROC)曲线分析、Spearman模型分析。结果观察组普通、重症患儿及对照组儿童NLR分别为1.5±0.3、2.2±0.3、1.2±0.2,LDH水平分别为(439.8±30.1)U/L、(528.6±35.6)U/L、(125.8±28.9)U/L,IL-6水平分别为(18.3±1.3)ng/L、(25.8±2.1)ng/L、(9.5±1.2)ng/L;观察组普通、重症患儿NLR、LDH、IL-6水平高于对照组(NLR:t=10.135、27.514,LDH:t=86.323、103.974,IL-6:t=44.834、84.297,P值均<0.05),且观察组普通患儿NLR、LDH、IL-6水平低于重症患儿(NLR:t=20.599,LDH:t=26.252,IL-6:t=48.065,P值均<0.05)。NLR、LDH、IL-6联合评估的曲线下面积(area under the curve,AUC)最大,为0.911,灵敏度、特异度分别为82.89%、89.42%;CPIS评分(OR=7.232,95%CI:5.055~10.347)、WBC(OR=6.839,95%CI:4.752~9.844)、PCT(OR=8.882,95%CI:6.375~12.374)、CRP(OR=11.520,95%CI:8.125~16.333)、NLR(OR=11.517,95%CI:7.852~16.894)、LDH(OR=11.881,95%CI:7.698~18.337)、IL-6(OR=12.424,95%CI:8.025~19.235)均为MPP患儿预后的独立危险因素(P值均<0.05);MPP患儿NLR、LDH、IL-6水平与CPIS评分、WBC、PCT、CRP均呈正相关(P值均<0.05)。结论MPP患儿NLR、LDH、IL-6水平明显升高,可作为MPP病情及预后评估的潜在指标。