摘要
目的探索中性粒细胞与淋巴细胞比值对急性胰腺炎严重性的预测作用。方法对2010年9月-2011年9月住院的96例急性胰腺炎病例进行分析。以Ranson评分≥3分为重症胰腺炎标准。对患者入院后首次血常规检查结果的白细胞总数、中性粒细胞与淋巴细胞比值进行均数比较,Spearman相关性检验、ROC分析以及计算预测的敏感性、特异性、阳性拟然比、阳性预测值及准确度。结果重症急性胰腺炎20例,轻症急性胰腺炎76例。重症急性胰腺炎患者白细胞总数明显较轻症急性胰腺炎患者白细胞总数多[(15.16±5.06)×109/L vs(11.05±1.76)×109/L,P=0.000],重症急性胰腺炎患者中性粒细胞与淋巴细胞比值明显较轻症急性胰腺炎患者的比值大(18.95±12.13 vs 6.63±3.44,P=0.000)。白细胞总数及中性粒细胞与淋巴细胞比值与SAP的Spearman相关系数分别为0.419、P=0.000及0.571、P=0.000。白细胞总数对重症急性胰腺炎预测的AUC为0.798(95%CI:0.670～0.925),最佳预测分界点为12.55×109/L;中性粒细胞与淋巴细胞比值对重症急性胰腺炎预测的AUC为0.906(95%CI:0.830～0.981),最佳预测分界点为7.85。白细胞总数和中性粒细胞与淋巴细胞比值预测重症急性胰腺炎的敏感性、特异性、阳性拟然比、阳性预测值及准确度分别为70.00%、86.84%、5.32、58.33%、83.33%和85.00%、92.11%、10.77、73.91%、90.63%。两者AUC比较,Z=4.59>1.96,P<0.05。结论中性粒细胞与淋巴细胞比值对急性胰腺炎严重性的预测具有较高的价值。
Objective To investigate the predictive value of neutrophils-lymphocytes ratio in the severity of acute pancreatitis. Methods The data of 96 hospitalized patients with acute pancreatitis （AP） from September 2010 to September 2011 were analyzed. The diagnostic standard of severe acute pancreatitis （SAP） was Ranson score ≥3. The white blood cell count （WBC）, neutrophils-lymphocytes ratio （NLR）, Spearman correlation test （rs）, ROC curves, area under the curve （AUC）, sensitivity （Se）, specificity （Sp）, positive likelihood ratio （PLR）, positive predictive value （PPV） and accuracy （Ac） were studied on the data of the first blood routine after admission. Results There were 20 cases with SAP and 76 cases with mild acute pancreatitis （ MAP）. The WBC in SAP group was siglificantly high- er than that in MAP group [ （ 15.16 ± 5.06） × 109/L vs （ 11.05 ± 1.76） × 109/L, P = 0. 000 ]. The NLR in SAP group was siglificantly higher than that in MAP group （18.95 ± 12.13 vs 6.63 ± 3.44 ,P =0. 000）. The rs of WBC and NLR in SAP were 0. 419 and 0. 571, respectively （P = 0. 000）. The WBC predictive cut off value was 12.55 × 109/L and the AUC was 0. 798 （95% CI ： 0. 670 - 0. 925）. The NLR predictive cut off value was 7.85 and the AUC was O. 906 （95% CI：0.830-0.981）. TheSe, Sp, PLR, PPV, Ac of WBC and NLR were 70. 00% , 86.84%, 5.32, 58.33%, 83.33% and 85.00% ,92. 11% , 10.77,73.91% ,90.63% , respectively. There was significant different between the two AUCs （Z = 4.59 〉 1.96,P 〈 0.05）. Conclusion There is a higher predictive value of NLR in the severity of AP.
出处
《胃肠病学和肝病学杂志》
CAS
2012年第6期574-577,共4页
Chinese Journal of Gastroenterology and Hepatology
