摘要
目的本研究对肺移植患者术后临床资料进行回顾性分析,分析中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)与肺移植早期预后的关联性。方法数据采集时段设定为南京医科大学附属无锡人民医院2020年1月1日至2021年12月1日,肺移植术后转入重症医学科的患者队列,30 d内临床结局显示:81例生存,39例死亡。采用多因素logistic回归模型识别术后30 d死亡的关键危险因素,并采用受试者工作特征(receiver operating characteristic,ROC)曲线进行分析,评估NLR对术后30 d死亡风险的预测能力,借助约登指数识别的最佳分界值对患者归组,继而绘制Kaplan-Meier生存曲线,对比各组生存结局。结果多因素logistic回归分析显示NLR(OR=1.11,95%CI:1.03~1.19,P=0.008)、机械通气时间(OR=1.01,95%CI:1.01~1.01,P=0.033)、PGD3级(OR=6.07,95%CI:1.85~19.97,P=0.003)可作为肺移植术后30 d病死率的独立预测因子。NLR预测肺移植患者30 d病死率的曲线下面积(area under the curve,AUC)为0.674,根据截断值进行分组绘制Kaplan-Meier生存曲线可见NLR>13.65组肺移植患者的30 d病死率显著高于NLR≤13.65组。结论术前NLR对于肺移植术后病人的短期结局有一定预测价值。
Objective To investigate the predictive value of preoperative neutrophil-to-lymphocyte ratio for the short-term outcome of patients after lung transplantation by retrospectively analyzing the clinical data of patients after lung transplantation.Methods The clinical data of 81 patients with good early prognosis of lung transplantation(30 d survival)and 39 patients with poor early prognosis of lung transplantation(30 d death)admitted to the Department of Critical Care Medicine of Wuxi People's Hospital affiliated with Nanjing Medical University from January 1,2020 to December 1,2021 were retrospectively analyzed.Independent risk factors for 30 d death in lung transplant patients were explored by multifactorial logistic regression analysis.The predictive value of the NLR ratio for 30 d postoperative death in lung transplant patients was analyzed by plotting the receiver operating characteristic(ROC)curve.The patients were also grouped according to the optimal cut-off value,and Kaplan-Meier survival curves were plotted.Results Multifactorial logistic regression analysis showed that NLR(OR=1.11,95%CI:1.03~1.19,P=0.008),mechanical ventilation time(OR=1.01,95%CI:1.01~1.01,P=0.033)and PGD grade 3(OR=6.07,95%CI:1.85~19.97,P=0.003)were independent risk factors for 30 d mortality in lung transplant patients.The area under the curve(AUC)of NLR for predicting 30 d mortality in lung transplant patients was 0.674,and grouping based on the cutoff value to plot the Kaplan-Meier survival curve showed that the 30 d mortality rate of lung transplant patients in the NLR>13.65 group was significantly higher than that in the NLR≤13.65 group.Conclusion Preoperative NLR has a certain predictive value for the short-term outcomes of patients after lung transplantation.
作者
朱溢超
李芝宇
许红阳
Zhu Yichao;Li Zhiyu;Xu Hongyang(Department of Critical Care Medicine,Wuxi People's Hospital Affiliated to Nanjing Medical University,Jiangsu Wuxi 214023,China)
出处
《实用器官移植电子杂志》
2025年第6期529-534,共6页
Practical Journal of Organ Transplantation(Electronic Version)
关键词
中性粒细胞与淋巴细胞比值
肺移植
早期预后
预测价值
Neutrophil-to-lymphocyte ratio
Lung transplantation
Short-term outcome
Predictive value
