中性粒细胞/淋巴细胞比值对急性一氧化碳中毒病情评估及预后的预测价值

韩永燕; 王岩; 赵国强; 王岚; 王维展

doi:10.13201/j.issn.1009-5918.2017.12.009

中性粒细胞/淋巴细胞比值对急性一氧化碳中毒病情评估及预后的预测价值

- 1. 河北医科大学附属哈励逊国际和平医院急救医学部(河北衡水, 053000);
- 2. 衡水市第二人民医院内科
基金项目:
河北省卫生计生委员会批准的科研基金 (No:20170234)

详细信息

通讯作者: 韩永燕,E-mail:hanyongyan.2008@163.coml

中图分类号: R595.1

收稿日期: 2017-08-06

The effect of neutrophil lymphocyte ratio on the evaulation and prognosis of acute carbon monoxide poisoning

- 1. Department of Emergency, Harrison International Peace Hospital, Hengshui, 053000, China;
- 2. Department of Internal Medicine, the Second People' Hospital of Hengshui

More Information

Corresponding author: HAN Yongyan, E-mail: hanyongyan.2008@163.coml

Received Date: 06 August 2017

摘要

摘要: 目的:研究中性粒细胞/淋巴细胞比值(neutrophil lymphocyte ratio,NLR)对急性一氧化碳中毒(ACOP)病情评估及预后的预测价值。方法:回顾性分析2015~2017年河北医科大学附属哈励逊国际和平医院急救医学部收治的ACOP患者,最后入组181例。根据ACOP的中毒程度分为3组:轻度ACOP组30例,中度ACOP组84例,重度ACOP组67例。采集性别、年龄、血压等一般资料,记录患者中毒后昏迷时间及入院时简易精神状态检查量表(MMSE)评分,测定入院时血常规、血糖、血脂、肌酐、凝血酶原时间、纤维蛋白原含量,并计算NLR值,对三组相关指标进行比较,并分析MMSE评分与NLR的关系。采用Logistics回归分析ACOP患者的危险因素,根据随访60d后是否出现迟发型脑病(DEACMP),分为预后良好组和不良组,采用受试者工作特征(ROC)曲线评价入院时NLR水平对ACOP预后不良的预测作用。结果:①轻度、中度及重度ACOP组的昏迷时间分别为:0,(3.86±4.30) h,(5.24±4.60) h,3组比较差异均有统计学意义(P<0.01)。3组血常规比较:WBC计数、NLR值差异均有统计学意义(P<0.01);3组生化指标中空腹血糖、凝血指标中纤维蛋白原含量差异均有统计学意义(P<0.05);NLR与MMSE评分成呈负相关(r=-0.278,P<0.01).②多项Logistic回归分析结果显示:NLR值(OR重度=1.037,95% CI:1.012~1.121,P<0.05)为重度ACOP的独立危险因素。③入院时NLR水平对ACOP预后不良的诊断界值为2.305,其敏感度为91.2%,特异度为61.5%。结论:NRL可用于评估ACOP病情;入院时NLR水平增高对ACOP患者出现迟发型脑病具有一定的预测价值。
- 中性粒细胞 /
- 淋巴细胞 /
- 比值 /
- 一氧化碳 /
- 中毒 /
- 预后
Abstract: Objective:To investigate the relationship between neutrophil to lymphocyte ratio (NLR) and acute carbon monoxide poisoning.Method:One hundred and eighty-one patients with acute carbon monoxide poisoning admitted to our hospital from 2015 to 2017 were retrospectively analyzed.All the patients were divided into mild group (n=30), moderate group (n=84) and severe group (n=67).The general information, age, sex, blood pressure, coma time and the minimental state examination (MMSE) score was collected.Routine blood cell test, blood glucose, blood lipid, Creatinine, prothrombin time and fibrinogen was detected.Then NLR was calculated.Compare the differences in all the data among three groups and to investigate the relationship between neutrophil to lymphocyte ratio (NLR) and MMSE score.Logistic regression analysis was used to analyze the influencing factors of poor prognosis of ACOP.The receiver operating characteristic curve (ROC) was used to evaluate the predictive effect of the NLR level on patients with ACOP on admission.Result:① There were significant differences among three groups in coma time (P<0.01), White blood cell count (P<0.01), NLR (P<0.01), fasting plasma glucose (P<0.01) and fibrinogen (P<0.05).The NLR on admission was negatively correlated with MMSE score (r=-0.278, P<0.01). ② Multivariate logistic regression analysis showed that the increase of NLR was independent risk factor for the severe ACOP (OR=1.037, 95%CI was 1.012~1.121, P<0.05). ③ The diagnostic cut-off value of the NLR level on admission for the poor prognosis of ACOP was 2.305, Its sensitivity was 91.2%, and specificity was 61.5%.Conclusion:NLR on admission can be used to evaluate the degree of ACOP, and can be used as a detection indicator for poor prognosis of ACOP.
- neutrophils /
- lymphocytes /
- ratio /
- carbon monoxide /
- poisoning /
- prognosis

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