摘要
目的探讨术后中性粒细胞淋巴细胞比值(NLR)动态变化对颅脑外伤术后患者颅内感染的预测价值.方法选取扬州大学附属医院重症医学科自2012年1月至2018年12月收治的116例颅脑外伤并发术后颅内感染患者.根据患者术后第3天NLR的检测结果,NLR≥3为高NLR组,NLR<3为低NLR组,比较2组患者的临床预后情况.结果高NLR组患者在术后第3天NLR值明显升高,与低NLR组比较差异具有统计学意义(2.24±0.68vs4.72±1.21,P<0.05).高NLR组患者颅内感染发生10例(19%),低NLR组颅内感染发生4例(6%),2组比较差异具有统计学意义(P=0.033).NLR:曲线下面积(AUC)=0.894,95%CI:0.795~0.993;PCT:AUC=0.895,95%CI:0.764~1.027;CRP:AUC=0.898,95%CI:0.814~0.981.高NLR组患者ICU入住时间和机械通气时间均长于低NLR组,差异具有统计学意义(18.4±8.7vs13.2±5.4,P=0.000;10.3±4.7vs5.3±4.1,P=0.000).高NLR组患者病死率高于低NLR组,差异具有统计学意义(P=0.026).结论术后升高的NLR对颅脑外伤术后患者颅内感染的发生具有较好的临床预测价值,升高的NLR值和不良预后密切相关.
Objective To explore the predictive value of dynamic changes of postoperative neutrophil lymphocyte ratio(NLR) in patients with craniocerebral trauma secondary intracranial infection.Methods One hundred sixteen patients with craniocerebral trauma secondary intracranial infection admitted to the Department of Critical Care Medicine, the Affiliated Hospital of Yangzhou University from January 2012 to December 2018 were included in the study. Patients were divided into a high NLR group(NLR ≥3) and a low NLR group(NLR <3) based on the NLR measured on the third day after surgery. The difference in clinical outcome between the two groups was compared. Results NLR values were significantly higher in the high NLR group on the third postoperative day, and there was a significant statistical difference compared with the low NLR group(2.24 ±0.68 vs 4.72±1.21, P<0.05). In the high NLR group, 10 patients(19%) had intracranial infection, and 4 patients(6%) in the low NLR group. There was a significant statistical difference between the two groups(P=0.033). NLR: area under the curve(AUC)=0.894, 95%CI: 0.795-0.993;PCT: AUC=0.895, 95%CI: 0.764-1.027;CRP: AUC=0.898,95%CI: 0.814-0.981. The ICU staying time and mechanical ventilation time were higher in the high NLR group than in the low NLR group. There was a statistical difference between the two groups(18.4 ±8.7 vs13.2±5.4, P=0.000;10.3±4.7 vs 5.3±4.1, P=0.000). The difference in mortality between the two groups was statistically significant. The mortality rate was higher in the high NLR group than in the low NLR group(P =0.026). Conclusion The elevated neutrophil lymphocyte ratio after surgery has a good clinical predictive value for the occurrence of intracranial infection in patients with craniocerebral trauma. The elevated NLR value is closely related to the poor prognosis.
作者
王玉荣
郑庆斌
韦广发
孟丽君
冯庆玲
袁文杰
欧金磊
刘微丽
李勇
Wang Yurong;Zheng Qingbin;Wei Guangfa;Meng Lijun;Feng Qingling;Yuan Wenjie;Ou Jinlei;Liu Weili;Li Yong(Department of Critical Care Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou 225001, China)
出处
《中华神经创伤外科电子杂志》
2019年第5期265-268,共4页
Chinese Journal Of Neurotraumatic Surgery：Electronic Edition
基金
扬州市社会发展项目(YZ2017080)
关键词
中性粒细胞淋巴细胞比值
颅脑外伤
颅内感染
Neutrophil lymphocyte ratio
Craniocerebral trauma
Intracranial infection
